National and subnational trends in cancer burden in China, 2005-20: an analysis of national mortality surveillance data

Construction of electrochemical immunosensors based on Au@MXene and Au@CuS nanocomposites for sensitive detection of carcinoembryonic antigen

Cancer is currently one of the major causes of human mortality and has received widespread attention. In this paper, Au@CuS composite nanomaterial as a sandwich immunosensor tag for carcinoembryonic antigen (CEA) detection strategy was studied. Herein, Au@CuS composite nanomaterials were obtained by Au nanoparticles modified with CuS, which were combined with secondary antibody (Ab2) to construct an immunosensor that interacted with H2O2 to produce a current response. The anti-CEA primary antibody (Ab1) was fixed on the glassy carbon electrode (GCE) modified by Au@MXene. The completed electrochemical immunosensor was constructed with rapid detection and high sensitivity for CEA. Under optimal conditions, the linearity ranged from 0.01 pg/mL to 0.5 ng/mL, and the detection limit was 3.8 fg/mL. This tactic possesses good reproducibility, constancy and selectivity. At the same time, this strategy has latent practical value for the test of other tumor markers.

Advances in the study of the role of gastric microbiota in the progression of gastric cancer

Gastric cancer (GC) is a common malignant tumor and the third most common cancer in China in terms of mortality. Stomach microorganisms play complex roles in the development of GC. The carcinogenic mechanism of Helicobacter pylori has been elucidated, and there is much evidence that other microorganisms in the gastric mucosa are also heavily involved in the disease progression of this cancer. However, their carcinogenic mechanisms have not yet been fully elucidated. The microbial compositions associated with the normal stomach, precancerous lesions, and GC are distinctly different and have a complex evolutionary mechanism. The dysregulation of gastric microbiota may play a key role in the oncogenic process from precancerous lesions to malignant gastric tumors. In this review, we explore the potential translational and clinical implications of intragastric microbes in the diagnosis, prognosis, and treatment of GC. Finally, we summarize the research dilemmas and solutions concerning intragastric microbes, emphasizing that they should be at the forefront of strategies for GC prevention and treatment.

The impact of cathepsins on liver hepatocellular carcinoma: Insights from genetic and functional analyses

Liver Hepatocellular Carcinoma (LIHC), ranked as the second deadliest cancer globally, poses a major health challenge because of its widespread occurrence and poor prognosis. The mechanisms underlying LIHC development and progression remain unclear. Cathepsins are linked to tumorigenesis in other cancers, but their role in LIHC is underexplored. This study employed integrative analyses, including Mendelian Randomization (MR), bulk RNA-sequencing (bulk-seq), single-cell RNA sequencing (scRNA-seq), immunohistochemical (IHC) analysis, and cellular experiments with siRNA technology, to investigate the role of cathepsin E (CTSE) in LIHC. MR analysis identified CTSE as a factor associated with increased LIHC risk. Prognostic analysis using TCGA data showed that higher CTSE levels are linked to poorer survival, establishing CTSE as an independent prognostic risk factor. Integrative transcriptome analysis revealed close relation of CTSE to the extracellular matrix. scRNA-seq from TISCH2 demonstrated that CTSE is predominantly expressed in malignant LIHC cells. IHC confirmed higher CTSE expression in LIHC tissues compared to peritumoral tissues. Functional assays, such as qRT-PCR, Western blot, cell proliferation, and colony formation experiments, demonstrated that siRNA-mediated CTSE knockdown in HepG2 and Huh7 cell lines notably suppressed cell proliferation and altered the FAK/Paxillin/Akt signaling cascade. This research enhances our comprehension of LIHC development, emphasizing CTSE as a promising prognostic marker and potential therapeutic target. Inhibiting CTSE could slow the progression of LIHC, presenting novel opportunities for therapeutic approaches.

Targeting HNRNPA2B1 to Overcome Chemotherapy Resistance in Gastric Cancer Stem Cells: Mechanisms and Therapeutic Potential

Gastric cancer (GC) remains a significant global health challenge, particularly due to the resistance of gastric cancer stem cells (GCSCs) to chemotherapy. This study investigates the role of heterogeneous nuclear ribonucleoprotein A2/B1 (HNRNPA2B1), a member of the heterogeneous nuclear ribonucleoproteins (hnRNPs), in modulating mitochondrial metabolic reprogramming and contributing to chemoresistance in GCSCs. Through extensive analysis of tumor cancer genome atlas (TCGA) and gene expression omnibus (GEO) datasets, HNRNPA2B1 was identified as a key regulator in GCSCs, correlating with poor prognosis and enhanced resistance to chemoresistance. CRISPR-Cas9 mediated knockout of HNRNPA2B1 in GCSCs led to a significant decrease in mitochondrial function, reduced migration, invasion, and sphere formation abilities, and markedly increased apoptosis. These changes were accompanied by a shift in metabolic activity, evidenced by decreased oxygen consumption and increased extracellular acidification. Our results highlight HNRNPA2B1 as a pivotal factor in sustaining the malignant phenotype of GCSCs and present it as a potential therapeutic target to improve chemotherapy efficacy in GC.

Experience of breast cancer patients participating in a virtual reality psychological rehabilitation: a qualitative study

OBJECTIVE

Breast cancer is one of the most common types of cancer in China and worldwide. Apart from cancer, a majority of breast cancer patients suffer from various psychological disorders concurrently. The purpose of this study is to understand the actual experiences of breast cancer patients participating in Virtual Reality (VR) for psychological intervention, and to provide a theoretical basis for the development of VR psychological rehabilitation in China.

METHODS

Twenty-three breast cancer patients who met the inclusion criteria were selected using purposive sampling method for this qualitative study. Semi-structured interviews were conducted to explore their experiences with VR psychological rehabilitation. The data were analyzed, summarized, and generalized using the Colaizzi analysis method.

RESULTS

The results of the interviews were consistent with the PAC structural analysis. Three themes and six sub-themes captured how patients felt about adopting VR for their psychological rehabilitation, including parent ego state (the feeling of loss when expectations are not met, improvement of sleep), adult ego state (relief of psychological stress, optimization, and recommendations for VR therapy), and child ego state (novel and fun immersive experience, contagiousness of variable emotions).

CONCLUSION

Breast cancer patients participating in the VR psychological rehabilitation had a favorable experience. To maximize the benefit of VR psychological rehabilitation, healthcare professionals should comprehensively assess the psychological state of breast cancer, optimize VR technology, and enable patients to enter the adult ego state. The new model of VR psychological rehabilitation needs to be further explored.

Antiproliferative activity of selenium-enriched coumarin derivatives on the SK-N-SH neuroblastoma cell line: Mechanistic insights

Thirty selenium-containing coumarin derivatives were synthesized and evaluated for inhibitory activity against 17 malignant tumor cell lines. Among these, compound 11i demonstrated the most potent inhibition of neuroblastoma SK-N-SH cells, with an IC50 of 2.5 ± 0.1 μM. Compound 11i notably inhibited SK-N-SH cell proliferation, migration, and invasion. Western blot and immunofluorescence analyses indicated that 11i increased the Bax/Bcl-2 protein expression ratio, promoted Cytochrome C release from mitochondria, and activated caspases 9 and 3, triggering the mitochondria-mediated apoptotic pathway and inducing endogenous tumor cell apoptosis. The compounds localized in the cytoplasm and co-localized with mitochondria, suggesting mitochondrial interaction and dysfunction. Computational docking studies revealed a strong binding affinity of 11i with Bcl-2 and mitochondrial G-quadruplexes. In a subcutaneous neuroblastoma-bearing mouse model, 11i showed notable anti-tumor efficacy with tumor inhibition rates of 79 % (10 mg/kg) and 93 % (20 mg/kg), exceeding that of cyclophosphamide. This study represents a novel finding on the anti-tumor activity of selenium-containing coumarin derivatives and provides a theoretical basis for developing coumarin-based therapeutics for neuroblastoma.

Trends, global comparisons, and projections of early onset colorectal cancer burden in China based on GBD study 2021

This study aimed to analyze the trends of early-onset colorectal cancer (EOCRC) among individuals aged 15 to 49 in China from 1990 to 2021 and compare them with global patterns using data from the Global Burden of Disease (GBD) study. The analysis focused on age-standardized incidence rates (ASIR), prevalence rates (ASPR), mortality rates (ASMR), and disability-adjusted life years (DALYs). Joinpoint regression was used to determine the average annual percentage change (AAPC), and the ARIMA model was employed to forecast trends from 2022 to 2050. Results showed a significant increase in ASIR and ASPR in China, with a more rapid rise compared to global trends. ASMR and DALYs showed a decline, indicating improved survival rates. However, the increasing DALYs in China suggest a growing health impact. The ARIMA projections indicate a continued increase in EOCRC burden in China, highlighting the need for enhanced prevention and early detection strategies. This study underscores the necessity for intensified public health interventions to address the rising incidence of EOCRC in China.

3D synergistic tumor-liver analysis further improves the efficacy prediction in hepatocellular carcinoma: a multi-center study

BACKGROUND

Besides tumorous information, synergistic liver parenchyma assessments may provide additional insights into the prognosis of hepatocellular carcinoma (HCC). This study aimed to investigate whether 3D synergistic tumor-liver analysis could improve the prediction accuracy for HCC prognosis.

METHODS

A total of 422 HCC patients from six centers were included. Datasets were divided into training and external validation datasets. Besides tumor, we also performed automatic 3D assessment of liver parenchyma by extracting morphological and high-dimensional data, respectively. Subsequently, we constructed a tumor model, a tumor-liver model, a clinical model and an integrated model combining information from clinical factors, tumor and liver parenchyma. Their discrimination and calibration were compared to determine the optimal model. Subgroup analysis was conducted to test the robustness, and survival analysis was conducted to identify high- and low-risk populations.

RESULTS

The tumor-liver model was superior to the tumor model in terms of both discrimination (training dataset: 0.747 vs. 0.722; validation dataset: 0.719 vs. 0.683) and calibration. Moreover, the integrated model was superior to the clinical model and tumor-liver model, particularly in discrimination (training dataset: 0.765 vs. 0.695 vs. 0.747; validation dataset: 0.739 vs. 0.628 vs. 0.719). The AUC of the integrated model was not influenced by AFP level, BCLC stage, Child-Pugh grade, and treatment style in training (6 months p value: 0.245-0.452; 12 months p value: 0.357-0.845) and validation (6 months p value: 0.294-0.638; 12 months p value: 0.365-0.937) datasets. With a risk score of 1.06, high- and low-risk populations demonstrated significant difference for progression-free survival (p < 0.001 in both datasets).

CONCLUSIONS

Combined with clinical factors, 3D synergistic tumor-liver assessment improved the efficacy prediction of HCC.

Laparoscopic jejunostomy during McKeown minimally invasive esophagectomy: a propensity score analysis

BACKGROUND

Nutrition is a key factor limiting the rapid recovery of patients undergoing esophagectomy, but there is as yet no consensus on the optimal route of nutritional support. This study aimed to evaluate the potential benefits of laparoscopic jejunostomy (Lap-J) in comparison to conventional nasoenteral tube (NT) feeding in patients who underwent McKeown minimally invasive esophagectomy (MIE).

METHODS

A total of 577 consecutive patients with esophageal squamous cell carcinoma (ESCC) who underwent McKeown MIE were included in this single-center retrospective study. They were divided into two groups based on whether or not an intraoperative jejunostomy tube (JT) was placed, and baseline information was made consistent between the 2 groups using propensity score matching (PSM).

RESULTS

After exclusion and matching, 149 patients were included in each of the 2 groups. Compared with NT, patients who received JT had a shorter postoperative length of stay (11d vs 9d, P = 0.002), lower perioperative albumin loss rate (0.17 vs 0.13, P = 0.023), and lower rates of postoperative pneumonia (23 vs 3, P < 0.001) and pleural effusion (16 vs 5, P = 0.027). There was no significant difference in the occurrence of anastomotic leakage (AL) between the 2 groups. But in the group of patients with AL, the jejunostomy group had a significantly lower rate of perioperative albumin loss (0.20 (0.14-0.26) vs 0.12 (0.08-0.16) P = 0.03) and readmission (8 (40.0) vs. 2 (7.4) P = 0.019).

CONCLUSIONS

Lap-J during the McKeown MIE has demonstrated good safety and feasibility, and it contributes to the recovery of AL, making its outcome safe and simple.

TRIAL REGISTRATION

National clinical trials registry: NCT06192212, registered January 4th, 2024.

The incidence, mortality, and survival rate of colorectal cancer in Xiamen, China, from 2011 to 2020

INTRODUCTION

Currently, nearly one-third of newly diagnosed Colorectal cancer (CRC) cases and associated deaths worldwide are from China. Among Chinese provinces, Fujian exhibited the highest CRC mortality rate. This study aims to analyze long-term trends of CRC epidemiology in Xiamen, Fujian, China.

METHODS

Data were obtained from various cancer surveillance systems, including the Xiamen Cancer Register system, the Xiamen Death Register system, and the household registration system. Trends in incidence, mortality and survival rates from 2011 to 2020 were analyzed using annual percent changes (APC) and average annual percent changes (AAPC), stratified by sex and residency status.

RESULTS

A total of 7,406 new cases and 3,726 CRC-related deaths were reported from Xiamen. The age-standardized of incidence and mortality rates were 26.09 per 100,000 and 12.70 per 100,000, respectively. The observed 5-year survival rate was 46.65%, with an age-standardized survival of 51.24%. CRC incidence in Xiamen is significantly increasing (AAPC = 4.90%). In contrast, trends in CRC mortality and survival rates are not significant. Urban areas exhibited higher rates of CRC incidence, mortality, and survival rate compared to rural areas, though rural areas showed a more marked upward trend.

CONCLUSIONS

The burden of CRC in Xiamen is notably high, with a concerning increasing in incidence. This underscores the urgent need for targeted strategies to address this public health challenges.

Uveal metastasis: clinical characteristics, treatment, and prognostic factors in a cohort of 161 patients in China

OBJECTIVE

To investigate the clinical and prognostic features of uveal metastasis in a Chinese population and compare these features across different primary cancers.

DESIGN

Retrospective cross-sectional study.

PARTICIPANTS

161 patients with uveal metastasis at Beijing Tongren Hospital.

METHODS

Clinical characteristics of the primary tumour and uveal metastasis, treatments and outcomes were reviewed. Tumor regression was assessed using B-scan ultrasonography to measure changes in tumor height.

RESULTS

Among 161 patients, 185 eyes had uveal metastasis. Lung cancer was the most common primary tumour (49.4%), followed by breast cancer (22.4%), kidney cancer (4.3%). Uveal metastasis was the initial cancer manifestation in 39 patients (24.2%). Unilateral involvement was predominant (86.3%), with the choroid being the most common site (91%). Compared with lung cancer and other cancers, breast carcinoma patients developed uveal metastasis at a younger age (p < 0.001), had a longer interval to uveal metastasis diagnosis (0.67, 4.19, and 6.27 years, p < 0.0001), were prone to be bilateral (11.1%, 9.1%, and 27.8%; p < 0.05) and exhibited lower tumour height (4.47 ± 2.49 mm and 4.88 ± 3.01 mm, 3.09 ± 2.46 mm; p < 0.01). Local treatments (133 eyes) included plaque radiotherapy (PRT, brachytherapy), transpupillary thermotherapy (TTT), anti-VEGF and enucleation. The tumour regression correlated with increased tumor height (r = 0.5699; p < 0.05) in eyes treated with PRT (n = 15). Despite effective local tumour control, the 1-year, 3-year, and 5-year survival rates were 72.61%, 31.82%, and 19.84%, respectively (n = 103). Among the 54 deceased patients, 27 (50%) died within one year following the diagnosis of uveal metastasis. The mean survival was 18.84 months. Extraocular metastasis correlated with shorter survival (p < 0.05).

CONCLUSION

This study provides a comprehensive analysis of uveal metastasis in Chinese patients, highlighting the distinct characteristics from various primaries. Although survival rates remain uncertain, local therapies were effective at achieving ocular tumor control, which aligns with the expectations for patients battling metastatic cancers.

Controlled Inflammation Drives Neutrophil-Mediated Precision Drug Delivery in Heterogeneous Tumors

Tumor heterogeneity remains a formidable obstacle in targeted cancer therapy, often leading to suboptimal treatment outcomes. This study presents an innovative approach that harnesses controlled inflammation to guide neutrophil-mediated drug delivery, effectively overcoming the limitations imposed by tumor heterogeneity. By inducing localized inflammation within tumors using lipopolysaccharide, it significantly amplify the recruitment of drug-laden neutrophils to tumor sites, irrespective of specific tumor markers. This strategy not only enhances targeted drug delivery but also triggers the release of neutrophil extracellular traps, further potentiating the anti-tumor effect. Crucially, this study demonstrates that potential systemic inflammatory responses can be effectively mitigated through neutrophil transfusion, ensuring the safety and clinical viability of this approach. In a murine breast cancer model, the method significantly impedes tumor growth compared to conventional treatments. This work offers a versatile strategy for precise drug delivery across diverse tumor types. The findings pave the way for more effective and broadly applicable cancer treatments, potentially addressing the long-standing challenge of tumor heterogeneity.

The prognostic value of serum testosterone to BMI ratio in Chinese males with prostate cancer treated by androgen deprivation therapy: a single-center study

OBJECTIVE

To investigate the prognostic value of serum testosterone combining with body mass index (BMI) on the prostate cancer (PCa) after androgen deprivation therapy (ADT).

METHODS

In this study, we included the patients from June, 2017 to June, 2022 who were diagnosed with PCa and received ADT. The data of these patients were reviewed and analyzed. The ratio of serum testosterone to BMI (T/BMI) was calculated and the patients were divided into high T/BMI and low T/BMI group based on the optimal T/BMI cutoff value.

RESULTS

A total of 84 patients were screened and divided into high T/BMI group (> 0.244) (n = 35) and low T/BMI group (≤ 0.244) (n = 49). Higher possibility of metastasis occurred in low T/BMI than high T/BMI group (P < 0.001) and the PFS in low T/BMI group was significantly lower (P < 0.001) compared to high T/BMI group. Serum testosterone in the high BMI group was significantly lower than that in the non-high BMI group. Testosterone, BMI, and T/BMI were significantly different in the tumor progression group than that in non-tumor progression group (P < 0.05). The result from univariate Cox regression analysis demonstrated that BMI (HR = 1.247, P = 0.001), testosterone (HR = 0.936, P = 0.009), T/BMI(HR = 1.036, P = 0.017), and the metastasis (HR = 1.593, P = 0.025) were significantly correlated with PFS. The result from multivariate Cox regression analysis demonstrated that T/BMI (HR = 1.037, P = 0.015) was significantly correlated with PFS.

CONCLUSION

T/BMI has a certain predicting value for the prognosis and correlated with PFS of the PCa patients. Higher level of BMI and lower level of testosterone are more associated with poor outcomes than those with low BMI and high testosterone.

Epidemiology of breast cancer in Chinese women from 1990 to 2021: a systematic analysis and comparison with the global burden

BACKGROUND

Breast cancer is a major global public health concern and a major cause of cancer-related mortality. In 2020, 8.3% of the total breast cancer deaths worldwide were reported from China, which highlighted the need to understand the epidemiological trends of breast cancer within the country. Therefore, this study aimed to analyse the trends in the breast cancer burden in China from 1990 to 2021 and compare them with global trends to provide insights for future prevention and control strategies.

METHODS

Data were sourced from the Global Burden of Disease database 2021, which includes comprehensive information on the disease burden across 204 countries from 1990 to 2021. We analysed six key indicators: the mortality, prevalence, incidence, disability-adjusted life years, years lived with disability, and years of life lost. Age-standardized rates were analysed using the global age structure as a reference. Joinpoint regression was employed to assess the annual percentage change and average annual percentage change.

RESULTS

In 2021, 3.75 million prevalent breast cancer cases, with 385,837 new breast cancer cases and 88,106 deaths due to breast cancer, were reported from China. The crude rates of the prevalence, incidence, mortality, disability-adjusted life years, years lived with disability, and years of life lost significantly increased in 2021 compared with 1990. The age-standardized rates per 100,000 women were 355.72 for prevalence (+ 103.22% from 1990), 37.00 for incidence (107.40%), 8.24 for mortality (-8.24%), 281.54 for disability-adjusted life years (-6.68%), 25.86 for years lived with disability (110.24%), and 255.69 for years of life lost (-11.62%). The burden of breast cancer has notably increased among the women above 40 years of age, peaking between the ages of 50 and 59 years, and the proportion of cases in women under 40 years has decreased.

CONCLUSIONS

The age-standardized rate of the mortality, disability-adjusted life years, and years of life lost of breast cancer decreased slightly in China; however, the age-standardized rate of the incidence, prevalence, and years lived with disability exhibited an upward trend between 1990 and 2021, thereby highlighting the need to improve treatment outcomes and formulate better policies for the prevention and control of breast cancer in China.

PAMAM/miR-144 nanocarrier system inhibits the migration of gastric cancer by targeting mTOR signal transduction pathway

Exogenous microRNA-144 (miR-144) is considered as a potential biological drug for gastric cancer because of its biological activity to inhibit the epithelial-mesenchymal transition (EMT). However, the specific molecular mechanisms have not been fully revealed. In addition, their vulnerability to degradation by RNA enzymes in the blood limits their bioavailability. In this paper, a polyamidoamine (PAMAM)-wrapped miR-144 (PAMAM/miR-144) is prepared as a nanocarrier system to protect miR-144 from nuclease degradation. The PAMAM/miR-144 nanocarrier system achieves the optimal antitumor activity against gastric cancer migration and reduce mTOR protein expression by transferring miR-144 into human gastric cancer HGC-27 cells. At the same time, the PAMAM/miR-144 nanocarrier system significantly decreases the EMT via targeting mTOR signal pathway in HGC-27 cells and noticeably inhibited the growth of subcutaneous gastric cancer xenografts in nude mice. PAMAM/miR-144 nanocarrier system has effectively improved the bioavailability of miR-144, thus providing a promising combination modality for anticancer therapy.

DPP4 promotes an immunoenhancing tumor microenvironment through exhausted CD8+ T cells with activating IL13-IL13RA2 axis in papillary thyroid cancer

BACKGROUND

Papillary thyroid cancer (PTC) is among the most prevalent forms of endocrine malignancy with a rapid rise in incidence rates worldwide; however, the composition and characteristics of its immune microenvironment is poorly understand. Here, this work investigated the precise function of Dipeptidyl peptidase 4 (DPP4) in tumor-infiltrated T cells within PTC by investigating its role in cytokine-mediated signaling pathways.

METHODS

TCGA and GEO data as well as human PTC specimens confirmed the expression of DPP4 in PTC. The CIBERSORT and TIMER tool were used to analyze the distribution of tumor-infiltrating immune cells in PTC. CD8+ T cells from PTC patient's peripheral blood were cultured and used in a three-dimensional model for direct co-culture with PTC tumors to investigate DPP4 function.

RESULTS

Bioinformatic analyses has uncovered a significant upregulation of DPP4, which enhances the survival and migration of PTC cells in vitro. DPP4 upregulation significantly correlated with advanced grades, stages, and poor progression-free survival. DPP4 influences immune function and the exhaustion of CD8+ T cells through the IL13-IL13RA2 axis. The inhibition of DPP4 reduces CD8+ T cell exhaustion and IL13 secretion, while also blocking the IL13-IL13RA2 axis, thereby promoting the mesenchymal-to-epithelial transition of PTC cells.

CONCLUSION

Blocking DPP4 leads to the conversion of exhausted CD8+ T cells with decreased IL13 level, resulting in downregulation of IL13RA2 to promote mesenchymal-to-epithelial transition of PTC cells. This highlights DPP4 as a potential therapeutic target, particularly between CD8+ T cells and PTC cells via IL13-IL13RA2 axis, and represents a novel avenue for combined immunotherapy in PTC.

Clinical Significance of Acyl-CoA Dehydrogenase Short Chain and Its Anti-tumor Role in Hepatocellular Carcinoma by Inhibiting Canonical Wnt/β-Catenin Pathway

BACKGROUND

The pathogenesis of hepatocellular carcinoma (HCC) emphasizes metabolic disorders. HCC patients showed abnormally low expression of Acyl-CoA dehydrogenase short chain (ACADS).

OBJECTIVES

This study aimed to elucidate the clinical significance and mechanistic role of ACADS in HCC.

METHODS

We investigated the expression patterns and significance of ACADS in HCC by analyzing multiple public databases and clinical samples (Chip data). Immunohistochemistry was employed to observe the expression levels of ACADS in HCC tissues. In vitro experiments involved silencing or overexpressing ACADS in HCC cell lines, with protein expression levels determined by Western blotting. Functional validation included CCK-8, Transwell, and scratch wound healing assays. TOPFlash and FOPFlash reporter gene assays, co-immunoprecipitation, and immunofluorescence were used to explore the interaction between ACADS and β-catenin.

RESULTS

ACADS was low expressed in HCC and was clinically associated with vascular invasion, TNM stage, and AFP levels. The low ACADS expression in HCC patients was negatively correlated with their survival. Overexpression of ACADS significantly suppressed the viability, migration, and invasive capacity of HCC cells, whereas silencing ACADS had the opposite effect. Mechanistically, co-immunoprecipitation experiments indicated that there was an interaction between ACADS and β-catenin. Overexpression of ACADS inhibited β-catenin activity and resulted in decreased nuclear β-catenin translocation and increased its cytoplasmic level. Immunofluorescence results also showed a decrease in β-catenin nuclear import following ACADS overexpression, whereas silencing ACADS led to an enhancement of its nuclear translocation.

CONCLUSION

ACADS emerges as a potentially valuable biomarker for HCC prognosis, exhibiting tumor-suppressive functions in HCC by participating in the regulation of β-catenin activity.

Regulation of the Cilia as a Potential Treatment for Senescence and Tumors: A Review

Millions of people worldwide die from malignant tumors every year, and the current clinical treatment is still based on radiotherapy and chemotherapy. Immunotherapy-adjuvant chemotherapy is widely applied, yet resistance to various factors persists in the management of advanced malignancies. Recently researchers have gradually discovered that the integrity of primary cilia is closely related to many diseases. The phenotypic changes in primary cilia are found in some cases of progeria, tumorigenesis, and drug resistance. Primary cilia seem to mediate signaling during these diseases. Hedgehog inhibitors have emerged in recent years to treat tumors by controlling signaling proteins on primary cilia. There is evidence for the use of anti-tumor drugs to treat senescence-related disease. Considering the close relationship between aging and obesity, as well as the obesity is the phenotype of many ciliopathies. Therefore, we speculate that some anti-tumor or anti-aging drugs can treat ciliopathies. Additionally, there is evidence suggesting that anti-aging drugs for tumor treatment, in which the process may be mediated by cilia. This review elucidates for the first time that cilia may be involved in the regulation of senescence, metabolic, tumorigenesis, and tumor resistance and hypothesizes that cilia can be regulated to treat these diseases in the future.

Development and validation of a clinic-radiomics model based on intratumoral habitat imaging for progression-free survival prediction of patients with clear cell renal cell carcinoma: A multicenter study

PURPOSE

To develop and validate a clinicoradiomics model based on intratumoral habitat imaging for preoperatively predicting of progression-free survival (PFS) of clear cell renal cell carcinoma (ccRCC) and analyzing progression-associated genes expression.

METHODS

This retrospective study included 691 ccRCC patients from multicenter databases. Entire tumor segmentation was performed with handcrafted process to generate habitat subregions based on a pixel-wise gray-level co-occurrence matrix analysis. Cox regression models for PFS prediction were constructed using conventional volumetric radiomics features (Radiomics), habitat subregions-derived radiomics (Rad-Habitat), and an integration of habitat radiomics and clinical characteristics (Hybrid Cox). Training (n = 393) and internal validation (n = 118) was performed in a Nanjing cohort, external validation was performed in a Wuhan and Zhejiang cohort (n = 227) and in a TCGA-KIRC (n =71) with imaging-genomic correlation. Statistical analysis included the area-under-ROC curve analysis, C-index, decision curve analysis (DCA) and Kaplan-Meier survival analysis.

RESULTS

Hybrid Cox model resulted in a C-index of 0.83 (95% CI, 0.73-0.93) in internal validation and 0.79 (95% CI, 0.74-0.84) in external validation for PFS prediction, higher than Radiomics and Rad-Habitat model. Patients stratified by Hybrid Cox model presented with significant difference survivals between high-risk and low-risk group in 3 data sets (all P < 0.001 at Log-rank test). TCGA-KIRC data analysis revealed 37 upregulated and 81 downregulated genes associated with habitat imaging features of ccRCC. Differentially expressed genes likely play critical roles in protein and mineral metabolism, immune defense, and cellular polarity maintenance.

Longitudinal changes in plasma Cystatin C and all-cause mortality risk among the middle-aged and elderly Chinese population

OBJECTIVE

Elevated plasma Cystatin C levels are associated with an increased mortality risk among middle-aged and elderly Chinese individuals. This study explores whether tracking the longitudinal changes in Cystatin C can improve the prediction of mortality risk and allow better risk stratification, jointly with baseline measurements.

DESIGN & METHODS

This analysis includes 3,195 participants from the China Health and Retirement Longitudinal Study who completed plasma Cystatin C measurements in two waves (2011 and 2015) and were followed through 2020. To evaluate the association between Cystatin C levels/changes and mortality risk, multivariate Cox proportional hazard models were employed, adjusting for potential confounders. Survival probabilities were compared using Kaplan-Meier curves and log-rank tests, while restricted cubic splines were utilized to illustrate any nonlinear relationships between Cystatin C levels and hazard ratios.

RESULTS

Participants in the highest quartile of baseline Cystatin C show an increased risk of mortality compared to those in the lowest quartile (hazard ratio (HR): 1.51, 95 % CI: 1.02-2.24, p = 0.04). Including longitudinal changes in Cystatin C further strengthens this association (HR: 1.81, 95 % CI: 1.20-2.74, p < 0.001). Kaplan-Meier plots show that baseline levels effectively stratify both the entire cohort and gender-specific subgroups (p < 0.001). Moreover, integrating baseline levels with the longitudinal changes in Cystatin C levels provides additional stratification benefits. The predictive performance significantly improves by including longitudinal changes in Cystatin C in baseline-only models, with the concordance index increasing from 0.745 to 0.839 and the area under the receiver operator characteristic curve rising from 0.751 to 0.845. Additionally, significant nonlinear relationships between changes in Cystatin C and HR are observed in the entire population, the males and the females (p = 0.003, 0.018, 0.025).

CONCLUSIONS

Dynamic monitoring of changes in Cystatin C could enhance the prediction of mortality risk among middle-aged and elderly individuals.

Global, regional, and national trends in drug use disorder mortality rates across 73 countries from 1990 to 2021, with projections up to 2040: a global time-series analysis and modelling study

Background

Drug use disorder (DUD) poses a major public health crisis globally, necessitating immediate attention to global trends and future projections to develop effective health policies and interventions. Thus, we aimed to estimate the global trends in DUD mortality rates from 1990 to 2021 and future projections of DUD deaths until 2040 across 73 countries.

Methods

In this time-series analysis and modelling study, we investigated the global trends in DUD mortality rates from 1990 to 2021 using the WHO Mortality Database and forecasted future trends through 2040. Global trend analysis was analysed using a locally weighted scatter plot smoother (LOESS) curve, and future projections were calculated based on a Bayesian age-period-cohort analysis. In addition, we performed a decomposition analysis to identify the variations in DUD deaths, specifically examining factors such as population growth, ageing, and epidemiological changes.

Findings

Of the 73 countries included in the analysis of DUD mortality, 45 were high-income countries (HICs), and 28 were low to middle-income countries (LMICs). The LOESS estimates of the global DUD mortality rate were 1.84 deaths per 1,000,000 people (95% CI, -0.44 to 4.12) in 1990 and 13.09 deaths per 1,000,000 people (95% CI, 10.74-15.43) in 2021. Notably, HICs showed a significant increase in DUD mortality from 1.43 deaths per 1,000,000 people (95% CI, -1.55 to 4.42) in 1990 to 17.19 deaths per 1,000,000 people (95% CI, 13.84-20.53) in 2021. A significant increase in DUD mortality was observed among individuals aged 25-64 and males. Our analysis also identified associations between DUD mortality rates and several log-transformed parameters, including Human Development Index (β, 14.92; p < 0.0001), Socio-demographic Index (β, 11.80; p < 0.0001), reverse Gender Gap Index (β, -12.02; p < 0.0001), and Gini coefficient (β, -1.84; p < 0.0001). From 1990 to 2021, the increase in the number of DUD deaths globally can be attributed to two prominent factors: epidemiological change and population growth. In HICs, the impacts of epidemiological changes for increasing DUD mortality rates were particularly prominent compared to other factors. In the Bayesian age-period-cohort models, the predicted number of global DUD deaths up to 2040 were estimated to increase from 25.95 deaths per 1,000,000 people (95% credible interval [CrI], 24.72-27.28) in 2021 to 38.45 (95% CrI, 30.48-49.33) in 2030, and 42.43 (95% CrI, 23.67-77.77) in 2040.

Interpretation

An increasing trend in global DUD mortality was observed from 1990 to 2021, especially in HICs. Future DUD deaths were also predicted to increase until 2040 at the global level. Therefore, these findings suggest urgent and proactive strategies for DUD to reduce the mortality rates related to DUD are needed. However, further prospective research that accounts for potential confounding factors, such as socioeconomic variables and the quality of reporting data from individual countries, is imperative for more accurate estimation.

Funding

National Research Foundation and Ministry of Science and ICT of South Korea.

CircBIRC6 affects prostate cancer progression by regulating miR-574-5p and DNAJB1

BACKGROUND

Prostate cancer (PCa) is among the three main types of cancer. Although prostate-specific antigen (PSA) is routinely tested, it has disadvantages, such as poor prognostic ability. Therefore, finding more PCa markers and therapeutic targets remains a subject of study. CircRNAs have been found to have regulatory roles in various diseases, such as diabetes, Central Nervous System (CNS) neuropathy, etc. where their application in cancer is even more valuable. Therefore, this paper aims to search for differentially expressed circRNAs in PCa and find downstream targeting pathways related to autophagy.

METHOD

By detecting the expression of circRNA in the samples, hsa_circ_0119816 was finally identified as the research target. The properties of circRNA were verified by RNase R, actinomycin D, and fluorescence in situ hybridization (FISH). The downstream target miRNAs and target proteins were predicted by an online database, and the targeting relationship was verified using dual luciferase and RNA Immunoprecipitation. The effects of circRNAs and their downstream signalling pathways on prostate cancer cell proliferation, migration, EMT and autophagy were examined by CCK-8, Transwell, immunofluorescence and Western blotting.

RESULTS

CircBIRC6 is highly expressed in prostate cancer samples. Knockdown of its expression inhibits cell proliferation, invasion, EMT and autophagy and promotes apoptosis. CircBIRC6/miRNA-574-5p/DNAJB1 is a molecular axis that regulates prostate cancer cells.

An investigation into the health status of the elderly population in China and the obstacles to achieving healthy aging

The phenomenon of population aging in China has evolved into an irreversible trend. The state places significant emphasis on the health-related initiatives for the elderly and has implemented pertinent policies. This study aims to identify the primary health issues affecting the elderly population in China, ascertain the key risk factors influencing their health, and offer a scientific foundation for the government to develop ongoing policies and strategies, as well as to allocate health resources efficiently. This study was conducted utilizing the nationwide surveillance and survey data collected by the National Center for Chronic and Noncommunicable Disease Control and Prevention, China. Descriptive statistics were employed to delineate the mortality rates, disease burden, prevalence of significant risk factors for chronic illnesses, as well as the incidence of disabilities and impairments among the elderly population in China. In 2019, the mortality rate of chronic non-communicable diseases among the elderly population in China aged 60 years and above was 31,238 per 100,000 individuals, representing 93.9% of all deaths. The disability-adjusted life years for males in the elderly population aged 60 years and above in 2019 totaled 103,850,000 person-years, while females accounted for 86,404,000 person-years. Among the elderly population in China, the top three diseases contributing to the highest Disability-Adjusted Life Years (DALYs) were stroke (19.202 million DALYs, representing 18.5% of the total DALYs), ischemic heart disease (13.895 million DALYs, 13.4%), and chronic obstructive pulmonary disease (COPD; 9.453 million DALYs, 9.1%). The primary risk factors associated with chronic diseases among the elderly population in China include inadequate consumption of fruits and vegetables, excessive intake of red meat, lack of physical activity, smoking, alcohol consumption, and being overweight or obese. There exist variations among genders, urban and rural areas, and regions. In 2015, the disability rate for activities of daily living (ADL) was notably high among the elderly population in China, reaching 19.4%. The prevalence of dysfunctions such as depressive symptoms, sleep disorders, and hearing loss is substantial. The prevalence of osteoporosis among the elderly in China is concerning. While China has achieved some progress in enhancing the health of the elderly, the current scenario of population aging in China is grave, and the health of the elderly continues to encounter numerous challenges. The prevalence of chronic diseases continues to be significant, with chronic conditions being the primary cause of mortality in the elderly population. Secondly, risk factors for chronic diseases persist among the elderly population, with a significant prevalence of smoking, alcohol consumption, and obesity. This issue is particularly serious in rural areas, showing an escalating trend that demands heightened attention. The prevalence of functional disorders among the elderly is notably high, and the issue of disability in this population segment is of significant concern. This study suggests five recommendations aimed at enhancing health-related policies and the health service system for the elderly, in response to the existing health challenges and demographic trends. The recommendations include creating an elderly-friendly environment, increasing government investment in elderly health, and addressing the aging population in China and so on to enhance the health outcomes of the elderly population in the country.

Attenuated sex-related DNA methylation differences in cancer highlight the magnitude bias mediating existing disparities

BACKGROUND

DNA methylation (DNAm) influences both sex differences and cancer development, yet the mechanisms connecting these factors remain unclear.

METHODS

Utilizing data from The Cancer Genome Atlas, we conducted a comprehensive analysis of sex-related DNAm effects in nine non-reproductive cancers, compared to paired normal adjacent tissues (NATs), and validated the results using independent datasets. First, we assessed the extent of sex differential DNAm between cancers and NATs to explore how sex-related DNAm differences change in cancerous tissues. Next, we employed a multivariate adaptive shrinkage approach to model the covariance of cancer-related DNAm effects between sexes, aiming to elucidate how sex impacts aberrant DNAm patterns in cancers. Finally, we investigated correlations between the methylome and transcriptome to identify key signals driving sex-biased DNAm regulation in cancers.

RESULTS

Our analysis revealed a significant attenuation of sex differences in DNAm within cancerous tissues compared to baseline differences in normal tissues. We identified 3,452 CpGs (Pbonf < 0.05) associated with this reduction, with 72% of the linked genes involved in X chromosome inactivation. Through covariance analysis, we demonstrated that sex differences in cancer are predominantly driven by variations in the magnitude of shared DNAm signals, referred to as "amplification." Based on these patterns, we classified cancers into female- and male-biased groups and identified key CpGs exhibiting sex-specific amplification. These CpGs were enriched in binding sites of critical transcription factors, including P53, SOX2, and CTCF. Integrative multi-omics analyses uncovered 48 CpG-gene-cancer trios for females and 380 for males, showing similar magnitude differences in DNAm and gene expression, pointing to a sex-specific regulatory role of DNAm in cancer risk. Notably, several genes regulated by these trios were previously identified as drug targets for cancers, highlighting their potential as sex-specific therapeutic targets.

CONCLUSIONS

These findings advance our understanding of how sex, DNAm, and gene expression interact in cancer, offering insights into the development of sex-specific biomarkers and precision medicine.

High-Intensity Focus Ultrasound Ablation in Prostate Cancer: A Systematic Review

Background/Objectives: Prostate cancer (PCa) outcomes vary significantly across risk groups. In early-stage localized PCa, the functional outcomes following radical prostatectomy (RP) can be severe, prompting increased interest in focal therapy, particularly High-Intensity Focused Ultrasound (HIFU). This study is to summarize the current clinical trials of HIFU on PCa. Methods: We reviewed clinical trials from major databases, including PubMed, MEDLINE, Scopus, and EMBASE, to summarize the current research on HIFU in PCa treatment. Results: The literature highlights that HIFU may offer superior functional outcomes, particularly in continence recovery, compared to RP and radiation therapy. However, the oncological efficacy of HIFU remains inadequately supported by high-quality studies. Focal and hemigland ablations carry a risk of residual significant cancer, necessitating comprehensive patient counseling before treatment. For post-HIFU monitoring, we recommend 3T magnetic resonance imaging (MRI) with biopsy at 6 to 12 months to reassess the cancer status. Biochemical recurrence should be defined using the Phoenix criteria, and PSMA PET/CT can be considered for identifying recurrence in biopsy-negative patients. Conclusions: Whole-gland ablation is recommended as the general approach, as it provides a lower PSA nadir and avoids the higher positive biopsy rates observed after focal and hemigland ablation in both treated and untreated lobes. Future study designs should address heterogeneity, including variations in recurrence definitions and surveillance strategies, to provide more robust evidence for HIFU's oncological outcomes.

Development and validation of machine learning models for predicting venous thromboembolism in colorectal cancer patients: A cohort study in China

BACKGROUND

With advancements in healthcare, traditional VTE risk assessment tools are increasingly insufficient to meet the demands of high-quality care, underscoring the need for innovative and specialized assessment methods.

OBJECTIVE

Owing to the remarkable success of machine learning in supervised learning and disease prediction, our objective is to develop a reliable and efficient model for assessing VTE risk by leveraging the fundamental data and clinical characteristics of colorectal cancer patients within our medical facility.

METHODS

Six commonly used machine learning algorithms were utilized in our study to predict the occurrence of VTE in patients with rectal cancer. In the modeling process, LASSO regression was employed to identify and exclude variables not associated with VTE. Additionally, hyperparameter tuning was conducted via 5-fold cross-validation to mitigate overfitting, and 200 bootstrap samples were used to adjust the apparent performance on the training set. The selection of the VTE assessment model was determined by a thorough evaluation of performance criteria, such as the AUC, ACC and F1 score.

RESULTS

The RF model exhibits consistent and efficient performance. Specifically, in the internally validation dataset, where generalizability was adjusted, the RF model achieved the highest scores across multiple metrics: AD-AUC (0.895), AD-ACC (0.871), AD-F1 (0.311), AD-MCC (0.316), AD-Precision (0.241), AD-Specificity (0.888). For external validation on unseen colon cancer data, the RF model also performed best in terms of ACC (0.728), F1 (0.292), MCC (0.225), Precision (0.192), and Specificity (0.740), with a suboptimal AUC of 0.745 and a Sensitivity (Recall) of 0.615. Additionally, the RF model demonstrates strong performance not only on the original dataset but also on datasets processed via alternative imbalance handling techniques.

CONCLUSIONS

Our research successfully established and validated a risk assessment model for assessing the risk of VTE in colorectal cancer patients.

CPNE7 promotes colorectal tumorigenesis by interacting with NONO to initiate ZFP42 transcription

Colorectal cancer (CRC) is the third most common cancer worldwide and the second leading cause of cancer-related death globally. Also, there is still a lack of effective therapeutic strategies for CRC patients owing to a poor understanding of its pathogenesis. Here, we analysed differentially expressed genes in CRC and identified CPNE7 as a novel driver of colorectal tumorigenesis. CPNE7 is highly expressed in CRC and negatively correlated with patients' prognosis. Upregulation of CPNE7 promotes proliferation and metastasis of cancer cells in vitro and in vivo, and vice versa. Mechanistically, CPNE7 interacts with NONO to initiate ZFP42 transcription, thus promoting CRC progression. Moreover, ZFP42 knockdown inhibits tumor cell proliferation and migration while promoting apoptosis. Notably, delivery of CPNE7 shRNA or the small molecule gramicidin, which blocks the interaction between CPNE7 and NONO, hinders tumor growth in vivo. In conclusion, our findings demonstrate that the CPNE7-NONO-ZFP42 axis promotes colorectal tumorigenesis and may be a new potential therapeutic target.

Burden of melanoma in China and its provinces from 1990 to 2021: an analysis for the Global Burden of Disease Study 2021

Background

The incidence of melanoma in China has been increasing over the past few decades. This study aimed to investigate the burden of melanoma at both national and subnational level in China, where the population is rapidly aging.

Methods

The annual melanoma data from 1990 to 2021 was collected from the Global Burden of Disease (GBD) 2021 China subnational study. Number of cases and age-standardized rates were estimated for incidence, mortality, prevalence, disability-adjusted life-years (DALYs) of melanoma by age and sex at subnational level with 33 province-level administrative units. Joinpoint regression model was used to evaluate the trends in disease burdens attributable to melanoma across time. A decomposition method was used to attribute changes in total deaths and DALYs to three explanatory components: population growth, population aging, and change of age-specific rates.

Results

Over the past 30 years, the age-standardized incidence rate (ASIR) of melanoma in China has shown an upward trend. The ASIR of melanoma in 2021 was 0.7 per 100,000 (95%UI 0.4-0.9), representing an increase of 89.2% (95% UI: 14.7-157.9%) from 1990. Among younger adults aged <60 years, melanoma was more common in men, whereas among older adults who were aged >60 years, it was more common in women. The ASIR was higher in the coastal provinces in 2021 and the age-standardized rates (ASR) of DALYs was generally higher in the western provinces. Total numbers of death and DALYs of melanoma increased over the study period, mainly driven by population aging in China.

Conclusion

China has experienced a substantial increase in the burden of melanoma from 1990 to 2021. It is beneficial to develop more targeted strategies for older adults populations, especially for women, to reduce the melanoma burden throughout China, particularly in some coastal and western provinces.

Outcomes of Intraoperative Radiotherapy for Locally Advanced Adenocarcinoma of the Esophagogastric Junction After Neoadjuvant Therapy: A Single-Arm, Phase 1 Trial From the Chinese National Cancer Center

BACKGROUND

The role of intraoperative radiotherapy (IORT) for adenocarcinoma of the esophagogastric junction (AEG) remains uncertain. Therefore, a prospective phase 1 trial was conducted to assess the safety and feasibility of IORT for locally advanced AEG.

METHODS

The study enrolled patients with AEG at stages II-IVA from January 2019 to September 2019. Eligible patients received esophagectomy and a single fraction of electron beam radiotherapy. The primary endpoint of the study was a safety profile for IORT. Additionally, survival outcomes and the locoregional recurrence rate (LRR) were compared between the non-IORT and IORT cohorts using propensity score-matching.

RESULTS

For 15 (93.8 %) of the 16 patients in the study, R0 resection was successfully achieved, with only one patient undergoing R1 resection. A total postoperative complication morbidity rate of 43.8 % (7/16) was observed, with major complications (Clavien-Dindo classification ≥3) in 12.5 % of the cases (2/16). Total treatment-related adverse events were reported for seven patients (43.8 %, 7/16). After matching, a lower LRR was observed in the IORT group than in the non-IORT group (0 % [0/12] vs 33.3 % [4/12]; p = 0.028). However, the two groups did not differ significantly in 3-year progression-free survival (PFS: IORT [50.9 %] vs non-IORT [53.4 %]; p = 0.93) or 3-year overall survival (OS: IORT [58.3 %] vs IORT [72.9 %]; p = 0.23).

CONCLUSIONS

The current study demonstrated favorable feasibility and safety of IORT for locally advanced AEG. Although IORT is beneficial for improving local control, it may not prolong PFS or OS for patients with locally advanced AEG. A phase 2 trial is warranted for further validation of these outcomes.

Radioimmunotherapy: a game-changer for advanced non-small cell lung cancer

Lung cancer, particularly non-small cell lung cancer (NSCLC), remains a leading cause of cancer-related deaths, with conventional treatments offering limited effectiveness in advanced stages, due to distant metastases and treatment resistance. Recent advancements in immunotherapy, specifically immune checkpoint inhibitors (ICIs), have shown promise, but their efficacy as standalone therapies are often insufficient. This has led to increased interest in combining ICIs with radiotherapy, known as radioimmunotherapy (iRT), to enhance treatment outcomes. This review explores the mechanisms that underlie the synergy between radiotherapy and immunotherapy. Radiotherapy can induce the "abscopal effect", eliciting systemic immune responses that reduce tumor burdens outside the treated area. It also increases the expression of major histocompatibility complex class I (MHC-I) on tumor cells, improving immune recognition. Furthermore, radiotherapy can modify the tumor microenvironment by inducing metabolic reprogramming to bolster anti-tumor immunity. We discuss strategies for optimizing iRT, including considerations of radiation doses, fractionation schedules, and treatment site selection, which significantly influence immune responses by enhancing MHC-I expression or promoting T-cell infiltration. Clinical evidence supports the efficacy of iRT in NSCLC and other cancers, though challenges in standardizing treatment protocols and managing side effects persist. Overall, radioimmunotherapy presents a promising approach to improving NSCLC treatment outcomes. Ongoing research into its mechanisms and the refinement of treatment may reshape clinical practice, offering more effective and personalized options for patients with advanced lung cancer. Further studies are essential to validate these findings and optimize therapeutic protocols.

Effectiveness of non-pharmacological interventions in managing symptom clusters among lung cancer patients: a systematic review

BACKGROUND

Non-pharmacological interventions, as complements to pharmacological treatments, are widely employed for managing symptom clusters in patients with lung cancer. Although numerous systematic reviews and meta-analyses have explored the effects of these interventions, most studies have centred on the broader cancer population and specific symptom clusters. This review aims to consolidate existing non-pharmacological interventions and assess their effectiveness in managing symptom clusters among lung cancer patients.

METHODS

A comprehensive literature search, encompassing eight databases from inception to October 1, 2024, was conducted. Two independent reviewers carried out the study selection, quality assessment, and data extraction. Methodological quality was evaluated using the Cochrane Risk-of-Bias 2 tool and the Risk of Bias in Non-randomized Studies of Interventions. The findings were synthesized narratively based on intervention type and supplemented by meta-analysis using RevMan 5.4 software. The study protocol was registered with PROSPERO (CRD42023467406).

RESULTS

This systematic review comprised 15 relevant studies involving 1,692 patients, published between 2011 and 2024. The analysis revealed the effectiveness of psychological, educational, and complementary or alternative medicine interventions in alleviating the severity of most symptom clusters. However, the efficacy of exercise-based and multimodal interventions remained inconclusive. The meta-analysis demonstrated a positive impact of non-pharmacological interventions on depression compared with the control conditions (SMD = -0.30, 95% CI [-0.46, -0.15], p < 0.01, I2 = 6%). Additionally, the educational intervention subgroup showed low heterogeneity and effectively improved fatigue (SMD = -0.50, 95% CI [-0.68, -0.33], p < 0.01, I2 = 0%).

CONCLUSIONS

Psychological and educational interventions have proven effective in managing symptom clusters in lung cancer patients. However, further research is needed to explore the effects of exercise, multimodal approaches, and complementary or alternative medicine. To enhance symptom management, future research could focus on core symptom clusters.

A nomogram for predicting survival based on hemoglobin A1c and circulating tumor cells in advanced gastric cancer patients receiving immunotherapy

BACKGROUND

Our study aimed to investigate the correlation between hemoglobin A1c (HbA1c), circulating tumor cells (CTCs) and prognosis in advanced gastric cancer (GC) patients who received immunotherapy and explore the potential prognostic predictors to develop a nomogram.

METHODS

We retrospectively enrolled 259 patients with advanced GC treated at Beijing Friendship Hospital between September 2014 and March 2024. Patients were divided into the immunochemotherapy cohort (ICT) and the chemotherapy (CT) cohort. Survival rate was calculated by Kaplan-Meier survival curve, and the differences were evaluated by log-rank test. The univariate and multivariate Cox proportional hazards regression model was used to identify factors independently associated with survival. A nomogram was developed to estimate 6-, 12-, and 18-month progression-free survival (PFS) probability based on the ICT cohort.

RESULTS

Patients achieved higher PFS in the ICT cohort than the CT cohort. We focused on the ICT cohort and constructed a nomogram based on the multivariate analysis, including five variables: age, PD-L1 expression, HbA1c, CTCs and CEA*. The concordance index value was 0.82 in the training cohort and 0.75 in the validation cohort. Furthermore, we proved the nomogram was clinically useful and performed better than PD-L1 expression staging system. Notably, we found high HbA1c level but not diabetes mellitus significantly affected the efficacy of ICT.

CONCLUSION

ICT showed better PFS than CT. In addition, HbA1c and CTCs were novel biomarkers to predict PFS in patients treated with ICT. The nomogram could predict PFS of advanced GC patients receiving ICT with increased accuracy and favorable clinical utility.

The RIG-I-like receptor signaling pathway triggered by Staphylococcus aureus promotes breast cancer metastasis

Host microbes are increasingly recognized as key components in various types of cancer, although their exact impact remains unclear. This study investigated the functional significance of Staphylococcus aureus (S. aureus) in breast cancer tumorigenesis and progression. We found that S. aureus invasion resulted in a compromised DNA damage response process, as evidenced by the absence of G1-phase arrest and apoptosis in breast cells in the background of double strand breaks production and the activation of the ataxia-telangiectasia mutated (ATM)-p53 signaling pathway. The high-throughput mRNA sequencing, bioinformatics analysis and pharmacological studies revealed that S. aureus facilitates breast cell metastasis through the innate immune pathway, particularly in cancer cells. During metastasis, S. aureus initially induced the expression of RIG-I-like receptors (RIG-I in normal breast cells, RIG-I and MDA5 in breast cancer cells), which in turn activated NF-κB p65 expression. We further showed that NF-κB p65 activated the CCL5-CCR5 pathway, contributing to breast cell metastasis. Our study provides novel evidence that the innate immune system, triggered by bacterial infection, plays a role in bacterial-driven cancer metastasis.

m6A-Methylated NUTM2B-AS1 Promotes Hepatocellular Carcinoma Stemness Feature via Epigenetically Activating BMPR1A Transcription

Purpose

Hepatocellular carcinoma (HCC) is one of the most lethal malignancies in the world. Oncofetal proteins are the optimal diagnostic biomarkers and therapeutic targets for HCC. As the most abundant modification in RNA, N6-methyladenosine (m6A) has been reported to be involved in HCC initiation and progression. However, whether m6A has oncofetal characteristics remains unknown.

Methods

Gene expression in HCC tissues and cells was detected using qPCR. The level of m6A methylation was determined using methylated RNA immunoprecipitation assay. The biological roles of NUTM2B-AS1 in HCC were detected using Cell Counting Kit-8, 5-ethynyl-2'-deoxyuridine incorporation, and spheroid formation assays. The mechanisms underlying the roles of NUTM2B-AS1 were explored using RNA immunoprecipitation (RIP), chromatin isolation by RNA purification (ChIRP), chromatin immunoprecipitation (ChIP), and assay for transposase-accessible chromatin (ATAC).

Results

NUTM2B-AS1 was identified as a novel oncofetal long noncoding RNA that was upregulated in the fetal liver and HCC and silenced in adult liver tissues. METTL3 and METTL16 induce m6A hypermethylation of NUTM2B-AS1. The m6A methylation levels of NUTM2B-AS1 exhibit oncofetal characteristics. m6A methylation upregulates NUTM2B-AS1 expression by increasing NUTM2B-AS1 transcript stability. m6A-methylated NUTM2B-AS1 promotes HCC cell proliferation and stemness via epigenetically activating BMPR1A expression. NUTM2B-AS1 specifically binds to BMPR1A promoter. m6A-methylated NUTM2B-AS1 is recognized by the m6A reader YTHDC2, which further binds to the H3K4 methyltransferase MLL1. m6A-methylated NUTM2B-AS1 recruits YTHDC2 and MLL1 to BMPR1A promoter, leading to increased H3K4me3 and chromatin accessibility at BMPR1A promoter. Functional rescue assays suggest that BMPR1A is a critical mediator of the oncogenic role of m6A-methylated NUTM2B-AS1 in HCC.

Conclusion

METTL3- and METTL16-mediated m6A methylation of NUTM2B-AS1 is a novel oncofetal molecular event in HCC that promotes HCC stemness via epigenetically activating BMPR1A transcription.

Supportive care needs and associated factors among caregivers of elderly patients with gastrointestinal cancer: an exploratory study

BACKGROUND

Gastrointestinal cancers, including gastric and colorectal cancers, are major contributors to cancer-related morbidity and mortality worldwide, placing significant burdens on patients and their informal caregivers. This study aims to evaluate the level of supportive needs among informal caregivers of patients with gastrointestinal cancer and to identify key factors influencing these needs.

METHODS

We conducted a descriptive survey involving 335 informal caregivers of patients with gastrointestinal cancer at a large hospital in Shanghai, China, from September 2023 to April 2024. Multivariate linear regression analysis was employed to examine potential factors affecting supportive needs, including demographic information, caregiver burden, and self-efficacy.

RESULTS

The average supportive needs score among the 335 caregivers was 113.59 ± 52.97. This score was positively correlated with caregiver burden (r = 0.363, P < 0.001), self-efficacy (r = 0.224, P < 0.001), and patients' Karnofsky Performance Status (KPS) score (r = 0.119, P < 0.05). Multivariate regression analysis revealed that the care experience, duration of caregiving, relationship (sibling), self-efficacy, caregiver burden, KPS score of patients, treatment duration of patients, and cancer type of patients were significant factors influencing the supportive care needs of caregivers for elderly gastrointestinal cancer patients (P < 0.05).

CONCLUSION

Informal caregivers of elderly patients with gastrointestinal cancer often have increased levels of supportive needs. Clinical practice should include comprehensive assessments of these needs and the development of targeted interventions to improve caregiving skills and reduce caregiver burden, thereby enhancing the quality of life for both caregivers and patients.

Global, Regional, and National Trends in Liver Disease-Related Mortality Across 112 Countries From 1990 to 2021, With Projections to 2050: Comprehensive Analysis of the WHO Mortality Database

BACKGROUND

Liver disease causes over two million deaths annually worldwide, comprising approximately 4% of all global fatalities. We aimed to analyze liver disease-related mortality trends from 1990 to 2021 using the World Health Organization (WHO) Mortality Database and forecast global liver disease-related mortality rates up to 2050.

METHODS

This study examined age-standardized liver disease-related death rates from 1990 to 2021, employing data from the WHO Mortality Database across 112 countries across five continents. The rates over time were calculated using a locally weighted scatter plot smoother curve, with weights assigned based on the population of each country. Furthermore, this study projected liver disease-related mortality rates up to 2050 using a Bayesian age-period-cohort (BAPC) model. Additionally, a decomposition analysis was conducted to discern influencing factors such as population growth, aging, and epidemiological changes.

RESULTS

The estimated global age-standardized liver disease-related mortality rates surged significantly from 1990 to 2021 across 112 countries, rising from 103.4 deaths per 1,000,000 people (95% confidence interval [CI], 88.16, 118.74) in 1990 to 173.0 deaths per 1,000,000 people (95% CI, 155.15, 190.95) in 2021. This upward trend was particularly pronounced in low- and middle-income countries, in Africa, and in populations aged 65 years and older. Moreover, age-standardized liver disease-related mortality rates were correlated with a lower Human Development Index (P < 0.001) and sociodemographic index (P = 0.001). According to the BAPC model, the projected trend indicated a sustained and substantial decline in liver disease-related mortality rates, with an estimated decrease from 185.08 deaths per 1,000,000 people (95% CI, 179.79, 190.63) in 2021 to 156.29 (112.32, 214.77) in 2050. From 1990 to 2021, age-standardized liver disease-related deaths surged primarily due to epidemiological changes, whereas from 1990 to 2050, the impact of population aging and growth became the primary contributing factors to the overall increase.

CONCLUSION

Global age-standardized liver disease-related mortality has increased significantly and continues to emerge as a crucial global public health issue. Further investigation into liver disease-related mortality rates in Africa is needed, and updating policies is necessary to effectively manage the global burden of liver disease.

Clinical research progress of fruquintinib in the treatment of malignant tumors

Malignant tumors represent an important cause of mortality within the global population. Tumor angiogenesis, recognized as one of the key hallmarks of malignant tumors, is crucial for supplying essential nutrients and oxygen for tumor growth. Vascular endothelial growth factor (VEGF) and its receptor (VEGFR) are key drivers of tumor angiogenesis. Targeted therapeutic interventions not only effectively inhibit tumor growth by specifically blocking tumor angiogenesis but have also made breakthroughs in the treatment of malignant tumors. Fruquintinib, an anti-angiogenic small molecule drug developed independently in China, functions as a potent tyrosine kinase inhibitor with high selectivity. It effectively curtails tumor growth by binding to and inhibiting VEGFR-1, VEGFR-2, and VEGFR-3. Additionally, fruquintinib offers several advantages including minimal off-target toxicity, robust resistance profiles, and commendable efficacy. This agent can be used alone or in combination with other treatments. It has shown high effectiveness and survival benefits across various malignant tumors such as colorectal cancer, gastric cancer, non-small cell lung cancer, breast cancer, and other malignant tumors. Therefore, this article conducts a systematic review encompassing the mechanism of action, pharmacokinetics, clinical efficacy, and safety profile of fruquintinib. Through this review, we aimed to offer a reference for the clinical application and subsequent development of fruquintinib.

Comprehensive pancancer analysis reveals that LPCAT1 is a novel predictive biomarker for prognosis and immunotherapy response

Lysophosphatidylcholine acyltransferase 1 (LPCAT1) is a crucial enzyme involved in phospholipid metabolism and is essential for maintaining the structure and functionality of biofilms. However, a comprehensive examination of the role of LPCAT1 across various cancer types is lacking. Multiple public databases have been utilized to examine LPCAT1 expression, genetic alterations, methylation, prognosis, biological function, and its relationship with antitumor immunity in different cancer types. The function of LPCAT1 in glioma, breast cancer and liver cancer cells was further verified using in vitro experiments. Our research indicated that LPCAT1 is upregulated in various cancers and is accompanied by a wide range of amplification mutations. Higher LPCAT1 expression was associated with poorer prognosis across multiple cancers. Further in vitro experiments demonstrated that interfering with LPCAT1 expression increased apoptosis in glioma, breast cancer and liver cancer cells and concurrently suppressed their proliferation and migration. Functional enrichment analysis revealed that LPCAT1-associated genes were primarily enriched in immune and cancer progression pathways, such as the JAK/STAT, MYC, and EMT, etc. Moreover, LPCAT1 expression was closely associated with immune cell infiltration and immune checkpoint-related gene expression. Interestingly, LPCAT1 expression levels were generally higher in patients in the immunotherapy response group. The combination of LPCAT1 and PDL1 serves as an effective predictor of immunotherapy response. In conclusion, LPCAT1 is involved in immune regulation and tumor progression and holds promise as a biomarker for predicting patient outcomes and immunotherapy efficacy.

An Oxidative Stress Nano-Amplifier for Improved Tumor Elimination and Combined Immunotherapy

Amplifying oxidative stress to disrupt intracellular redox homeostasis can accelerate tumor cell death. In this work, an oxidative stress amplifier (PP@T) is prepared for enhanced tumor oxidation therapy to reduce tumor growth and metastases. The nano-amplifier has been successfully constructed by embedding MTH1 inhibitor (TH588) in the PDA-coated porphyrin metal-organic framework PCN-224. The controllable-released TH588 is demonstrated from pores can hinder MTH1-mediated damage-repairing process by preventing the hydrolysis of 8-oxo-dG, thereby amplifying oxidative stress and exacerbating the oxidative DNA damage induced by the sonodynamic therapy of PP@T under ultrasound irradiation. Furthermore, PP@T can effectively induce immunogenic cell death to trigger systemic anti-tumor immune response. When administered in combination with immune checkpoint blockade, PP@T not only impedes the progression of the primary tumor but also achieves obvious antimetastasis in breast cancer murine models, including orthotopic and artificial whole-body metastasis models. Furthermore, the nanoplatform also provides photoacoustic imaging for in vivo treatment guidance. In conclusion, by amplifying oxidative stress and reactive oxygen species sensitized immunotherapy, this image-guided nanosystem shows potential for highly specific, effective combined therapy against tumor cells with negligible side-effects to normal cells which will provide a new insight for precise tumor treatment.

Preoperative malnutrition in elderly gastric cancer patients and adverse postoperative outcomes of radical gastrectomy

Malnutrition is not only a prevalent condition among the elderly but also a common comorbidity in elderly people with gastric cancer (GC). Malnutrition is closely linked to high rates of postoperative complications and poor wound healing in elderly GC patients, which may lead to a higher incidence and mortality rate of GC. Malnutrition decreases the physical function of elderly GC patients after surgery, severely affecting their postoperative life quality and hindering subsequent treatments. This retrospective study was conducted by Zhao et al, focusing on the clinical baseline data, postoperative complications, and hospitalization times of elderly GC patients who underwent curative gastrectomy. Additionally, the underlying causes of poor outcomes for patients were discussed. This study may provide a solid basis for the clinical treatment of elderly GC patients in the future. Therefore, malnutrition can serve as a negative prognostic factor for curative surgery in GC patients. Addressing malnutrition and its adverse effects can benefit elderly GC patients from surgical treatment.

TTK promotes HER2 + breast cancer cell migration, apoptosis, and resistance to targeted therapy by modulating the Akt/mTOR axis

BACKGROUND

HER2 + breast cancer is a malignant neoplasm with a high degree of aggressiveness and therapeutic challenge. In recent years, studies have indicated a strong correlation between TTK and various tumors, though its role in HER2 + BRCA remains unclear.

OBJECTIVES

Studying the biological function of the TTK gene in HER2 + BRCA and its resistance to targeted therapy it provides new ideas for targeted drug research.

METHODS

TTK was knocked down by small interfering RNA transfection, and its biological function in HER2 + BRCA cells was verified, and its mechanism of action was verified by RT-PCR and Western blot.

RESULTS

The study demonstrated that TTK promoted cell proliferation and migration by activating the Akt/mTOR pathway in HER2 + breast cancer and enhanced the drug sensitivity of BRCA cell lines SKBR3 and BT474 to pyrotinib, in addition, knockdown of TTK induced apoptosis and arrested cells in G1 phase.

CONCLUSION

Which implies that TTK is an oncogene in HER2 + BRCA and is a valuable research target.

National and Subnational Trends of Mortality and Years of Life Lost Due to Stroke and Its Subtypes in Young Adults in China, 2005-2020

BACKGROUND AND OBJECTIVES

The incidence of stroke among young adults was rising globally, but the death burden of stroke in young adults in China is lacking. We aimed to examine the temporal trends in mortality and years of life lost (YLLs) caused by stroke among young adults from 2005 to 2020 across China.

METHODS

Based on the data from the National Mortality Surveillance System in China, we estimated the number and age-standardized rate of mortality and YLLs due to stroke and its subtypes among young adults aged 15-49 years during 2005-2020, for both China and its 31 mainland provinces.

RESULTS

During 2005-2020, the age-standardized mortality rate of stroke among young adults aged 15-49 years in China decreased by 21.0%, from 5.9/100,000 to 4.7/100,000, and the YLL rate decreased from 286.9/100,000 to 229.5/100,000. The age-standardized mortality rate among young adults due to intracerebral hemorrhage (ICH) showed a significant downward trend with a decrease of 26.3% while that of ischemic stroke (IS) and subarachnoid hemorrhage (SAH) decreased by 4.5% and 0.6%, respectively. In 2020, the mortality rate of ICH was 3.5 times higher than that of IS (3.3/100,000 vs 0.9/100,000) among young adults in China. The male/female ratio of age-standardized mortality rate of stroke in young adults increased from 2.0 in 2005 to 3.1 in 2020. The age-standardized mortality rate of IS and SAH in young men increased by 11.0% and 2.5%, respectively. In 2020, Tibet (18.4/100,000), Jilin (10.4/100,000), and Qinghai (8.3/100,000) were the top 3 provinces holding the highest age-standardized mortality rate due to stroke among young adults. Tibet was found to have the highest mortality rate due to ICH and SAH while that of IS was higher in northeast China.

DISCUSSION

In China, the death burden caused by ICH among young adults was substantially higher than that of IS. The increasing death burden of IS and SAH among young men requires special attention. Evidence-based intervention strategies are needed to improve the outcomes of stroke and alleviate the death burden due to stroke among young adults in Chinese population.

Photodynamic therapy with NIR-II probes: review on state-of-the-art tools and strategies

In 2022 10% of the world's population was aged 65+, and by 2100 this segment is expected to hit 25%. These demographic changes place considerable pressure over healthcare systems worldwide, which results in an urgent need for accurate, inexpensive and non-invasive ways to treat cancers, a family of diseases correlated with age. Among the therapeutic tools that gained important attention in this context, photodynamic therapies (PDT), which use photosensitizers to produce cytotoxic substances for selectively destroying tumor cells and tissues under light irradiation, profile as important players for next-generation nanomedicine. However, the development of clinical applications is progressing at slow pace, due to still pending bottlenecks, such as the limited tissue penetration of the excitation light, and insufficient targeting performance of the therapeutic probes to fully avoid damage to normal cells and tissues. The penetration depth of long-wavelength near infrared (NIR) light is significantly higher than that of short-wavelength UV and visible light, and thus NIR light in the second window (NIR-II) is acknowledged as the preferred phototherapeutic means for eliminating deep-seated tumors, given the higher maximum permissible exposure, reduced phototoxicity and low autofluorescence, among others. Upon collective multidisciplinary efforts of experts in materials science, medicine and biology, multifunctional NIR-II inorganic or organic photosensitizers have been widely developed. This review overviews the current state-of-the art on NIR-II-activated photosensitizers and their applications for the treatment of deep tumors. We also place focus on recent efforts that combine NIR-II activated PDT with other complementary therapeutic routes such as photothermal therapy, chemotherapy, immunotherapy, starvation, and gas therapies. Finally, we discuss still pending challenges and problems of PDT and provide a series of perspectives that we find useful for further extending the state-of-the art on NIR-II-triggered PDT.

Current status of short video as a source of information on lung cancer: a cross-sectional content analysis study

Background

The morbidity and mortality rates of lung cancer continue to rise, leading to a significant disease burden. Health education on lung cancer serves as an effective approach for prevention and treatment. With the increasing popularity of the Internet, an escalating number of patients are turning to video platforms for health information. Short videos facilitate better absorption and retention of information, thus becoming the primary channel for health education communication. However, the quality of information provided in videos on these platforms remains uncertain. Therefore, this study aims to assess the information quality pertaining to lung cancer in short videos available on a Chinese video platform.

Methods

Lung cancer-related videos on two short video platforms (TikTok and Kwai) were screened, and only Chinese (Mandarin) videos were included. The Global Quality Score (GQS) and modified DISCERN (mDISCERN) tools were then used to evaluate the quality and reliability of the information. A comparative analysis was conducted on videos from various sources. Additionally, correlation analysis was employed to investigate the factors influencing video quality.

Results

After screening, a total of 186 videos were included. The median GQS score and mDISCERN score were 3 (IQR: 3-4) and 2 (IQR: 2-4), respectively. A total of 44.1% of the lung cancer videos provided a comprehensive explanation of the symptoms, while only 3.2% fully explanation the complications associated with lung cancer. Health professionals, particularly specialists, demonstrated higher quality video information compared to individual users (P<0.001). The correlation coefficient between GQS score and mDISCERN score was 0.340, showing a significant positive correlation (P<0.001). In addition, GQS score was positively correlated with video duration (r=0.177, P=0.015).

Conclusion

The information quality of the 186 videos screened by the two platforms in this study was generally unsatisfactory. However, videos provided by experts were deemed relatively reliable, with video duration being closely associated with information quality. Therefore, it is crucial to meticulously screen high-quality and dependable videos on the platform in order to effectively guide lung cancer prevention and treatment.

Impact of METTL3/14/16 Gene Polymorphisms on Risk of Breast Cancer in Chinese Women

OBJECTIVES

Methyltransferase-like 3/14/16 (METTL3/14/16) presents the regulating valve in N6-methyladenosine (m6A) modification, involved in carcinogenesis. We addressed elucidating the relationship between single-nucleotide polymorphisms (SNPs) of the METTL3/14/16 gene and breast cancer (BC) susceptibility.

STUDY DESIGN

A case-control study included 680 BC patients and 680 healthy controls, individually matched for age (±2 years).

METHODS

7 SNPs were screened by bioinformatics tools. Conditional Logistic analysis was used to explore the association between SNPs and BC susceptibility. SNPs-reproductive factors interaction was assessed. qRT-PCR was conducted to detect the METTL3/14/16 expression of different SNPs. The potential biomechanism was explored using bioinformatics tools.

RESULTS

Among the 7 analyzed SNPs, METTL3 rs1061026 T>G exhibited a significant association with reduced susceptibility to BC. The TC+CC genotype of METTL14 rs428409 elevated BC risk, while the AG+GG genotype of METTL14 rs3087958 restrained BC risk. The stratified analysis further identified the protective effect of rs1061026 T>G and rs3087958 T>G, and the detrimental effect of rs428409 T>G in specific subgroups. Haplotype analysis revealed that haplotypes Grs1061026Crs1061027 and Grs368669Trs428409Grs3087958 were protective for BC. BC patients who carried the C allele in METTL14 rs428409 were more likely to be HER-2 positive. Individuals with age at menarche ≥14, number of pregnancies >1, and G allele in rs1061026 had a 47.7% decreased risk of BC. There were considerable multiplicative interactions between SNPs and reproductive factors. The relative expression of METTL3/14 was altered due to rs1061026 T>G, rs428409 T>C, and rs3087958 A>G. These three SNPs might interfere with the m6A modification and the expression level of BC-related genes.

CONCLUSION

Our findings suggested that rs1061026 T>G, rs428409 T>C, and rs3087958 A>G might be associated with the risk of BC.

Worldwide Research Trends and Regional Differences in the Development of Precision Medicine Under Data-Driven Approach: A Bibliometric Analysis

Background

Precision medicine is an innovative approach that integrates genomics, clinical informatics, and proteomics to address both genetic and environmental factors in disease prevention and treatment. This bibliometric study analyzes research trends, collaboration patterns, and the unique characteristics of precision medicine across countries to inform future research directions.

Methods

A comprehensive search was conducted in the Web of Science Core Collection (1999-2022) database to identify publications related to precision medicine. The analysis of publication patterns, collaborations, institutions, authors, and research hotspots was performed utilizing Microsoft PowerPoint 2019 in conjunction with the Bibliometrix package in R.

Results

A total of 30,777 publications on precision medicine were identified. The United States and the United Kingdom were recognized as the primary contributors, while European countries exhibited substantial collaborative efforts. Harvard University and the University of California System have played pivotal roles in advancing the field. The keywords analysis showed that in the early 2000s, "gene expression" and "personalized outcomes" were key themes. Since 2015, there's been a significant shift towards advanced technologies like artificial intelligence, machine learning, liquid biopsy, highlighting their growing importance in precision medicine. Research topics across various countries exhibit certain global similarities. However, different nations exhibit distinct thematic research focuses. China emphasizes "Informatics", "Hepatocellular Carcinoma", "Photothermal Therapy", and "Lung Adenocarcinoma", while the United States prioritizes "Informatics", "Treatment Rules", and "Consortium Guidelines". Germany and France share similar interests in particular research domains.

Conclusion

Precision medicine is rapidly globalizing, with significant contributions from multiple countries and emerging technologies acting as catalysts for further development. Greater international cooperation is essential to elevate the quality and impact of research. These advancements hold great potential for transforming personalized healthcare by integrating cutting-edge scientific disciplines.

Correlation of enlarged perivascular spaces in basal ganglion and cancer-associated stroke: a case-control study in China

INTRODUCTION

The incidence of cancer-associated ischaemic stroke (IS) is increasingly prevalent. This study aimed to assess the levels of enlarged perivascular spaces in basal ganglion (BG-EPVS) in cancer-associated patients who had a stroke compared with the control group, and to investigate the diagnostic utility of BG-EPVS in the context of cancer-associated stroke.

METHOD

A matched case-control study was conducted in Xiamen, China. A total of 184 IS patients (cancer vs control=1:1) were recruited. The severity of BG-EPVS was graded using high-resolution MRI. Patients' gender, age, clinical risk factors, other imaging changes and laboratory findings information at admission were collected. Logistic regression models were constructed and subgroup analysis by cancer treatment.

RESULT

Overall, 65.22% of the 184 subjects were male, with a mean (SD) age of 68.83±10.52 years. BG-EPVS had a significant influence on cancer-associated stroke (OR=1.85 (95% CI 1.29, 2.71), p=0.001) after adjusting for gender, age, clinical risk factors, other imaging changes and laboratory findings. The area under the curve of the diagnosis model that combined BG-EPVS and other factors was 0.848 (95% CI 0.787, 0.896), significantly higher than the other three models. Subgroup analysis suggested a heightened association between BG-EPVS and cancer-associated stroke within the cancer treatment group.

CONCLUSION

In conclusion, this is the first study to assess the diagnosis values of BG-EPVS on cancer-associated stroke and helps us understand the pathogenesis of cancer-associated stroke. Our findings demonstrate the effectiveness of BG-EPVS in diagnosing IS patients who may carry underlying cancer.

Nutritional guidance needs and influence factors for gastric cancer survivors in primary healthcare setting: a cross-sectional survey

PURPOSE

This study aimed to build a comprehensive understanding of the nutritional guidance needs of gastric cancer survivors in the primary healthcare setting that could be fulfilled by community health service centers as part of their primary healthcare services.

METHODS

Gastric cancer survivors were invited to participate in a questionnaire-based survey by convenience sampling method from the community health center. Relationships between nutritional demand and potential influence factors were examined by a multivariable logistic regression model.

RESULTS

A total of 200 gastric cancer survivors were recruited from the community health service center in Shanghai, China, from whom we obtained 194 valid questionnaires, resulting in a 97.0% response rate. Of these gastric survivor participants, 48 individuals (24.7%) expressed a need for nutritional guidance administered by community health service centers, whereas 146 participants (75.3%) held the perspective that such guidance was unnecessary. Preferences for nutritional guidance included having a dietitian as the provider (68.8%), home-based engagement (72.9%), face-to-face consultation (68.8%), individual counseling (87.5%), and beginning immediately post-discharge (89.6%). A notable reluctance (66.7%) towards financial contribution was also observed. After adjusting for confounders, participants with higher income level (odds ratio (OR) = 4.45, 95% confidence interval (CI) = 1.39-15.50), history of food intake reduction (OR = 14.96, 95% CI = 3.49-82.28), and gastrointestinal symptoms (OR = 4.40, 95% CI = 1.35-14.33) were more likely to seek nutritional guidance.

CONCLUSIONS

Gastric cancer survivors have a certain need for nutritional guidance administered by primary health service centers. Personal guidance by the primary health service center should be provided to gastric cancer survivors to support their dietary and nutritional intake needs.

IMPLICATIONS FOR CANCER SURVIVORS

There is a need to develop and implement nutritional guidance programs in community health service centers as part of their primary healthcare services for gastric cancer survivors.