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08 August 2025, Volume 52 Issue 8 Previous Issue   

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Expert consensus on the clinical diagnosis and treatment of post-obstructive pneumonia in newly diagnosed lung cancer patients Radiation Oncology Professional Committee of the Chinese Research Hospital Association, Hebei Society of Mathematical and Physical Medicine, Tianjin Precision Medicine Society 2025, 52 (8):  484-494.  doi: 10.3760/cma.j.cn371439-20250606-00083 Abstract ( 7 )   HTML ( 1 )   PDF (1029KB) ( 3 )   Save Pneumonia is a major contributor to morbidity and mortality in patients with lung cancer. Lung cancer complicated with obstructive pneumonia refers to a secondary infection that develops when a tumor partially or completely occludes an airway， causing inadequate ventilation of the distal lung parenchyma. Because of its complex pathogenesis and atypical clinical presentation， obstructive pneumonia frequently interferes with anticancer therapy and thus warrants heightened vigilance among clinicians. For patients presenting at initial diagnosis with concurrent obstructive pneumonia， balancing anti‐infective treatment against antitumor therapy is particularly critical. Drawing on the latest domestic and international literature and integrating recent advances in the field， this consensus offers 12 evidence-based recommendations addressing the pathogenesis， diagnostic criteria， prioritization of anti-infective versus antitumor interventions， and other common clinical challenges in managing lung cancer complicated by obstructive pneumonia， with the goal of optimizing therapeutic decision‐making for frontline clinicians. Figures and Tables | References | Related Articles | Metrics

Original Article

Observation on the therapeutic effect of atezolizumab combined with anlotinib in treating advanced non-small cell lung cancer Zhao Fang, Jiang Guorong, Shi Shuyue, Xiao Jian, Ma Shaolin, Li Runpu 2025, 52 (8):  495-501.  doi: 10.3760/cma.j.cn371439-20241108-00084 Abstract ( 7 )   HTML ( 1 )   PDF (1101KB) ( 1 )   Save Objective To explore the efficacy of atezolizumab combined with anlotinib in treating advanced non-small cell lung cancer （NSCLC）. Methods A total of 80 patients with advanced NSCLC treated in the Baoding No.2 Central Hospital from September 2019 to September 2023 after second-line treatment were selected as research subjects. Patients who received only anlotinib treatment were included in the monotherapy group （n=40）， while patients who received atezolizumab combined with anlotinib treatment were included in the combination group （n=40）. The clinical efficacy and serum levels of carcinoembryonic antigen （CEA） and vascular endothelial growth factor （VEGF） of the two groups were compared. Kaplan-Meier survival curve was used to analyze the survival of the two groups. The functional assessment of cancer therapy-lung cancer （FACT-L） was used to assess the quality of life of patients in both groups before and after treatment. The incidence of adverse reactions was compared between the two groups. Results After four cycles of treatment， the objective response rate （ORR） of the combination group was 37.50% （15/40）， which was higher than that of the monotherapy group [17.50% （7/40）]， with a statistically significant difference （χ2=4.01， P=0.045）. The disease control rates （DCRs） of the two groups were 85.00% （34/40） and 75.00% （30/40）， respectively， with no statistically significant difference （χ2=1.25， P=0.264）. Before treatment， the CEA levels in combination group and monotherapy group were （10.18±2.15） and （10.14±2.02） μg/L， and the VEGF levels were （804.04±46.58） and （809.10±43.63） ng/L， respectively， with no statistically significant difference （both P>0.05）. After treatment， the serum CEA levels of patients in combination group and monotherapy group were （4.35±1.05） and （6.63±1.37） μg/L， and the VEGF levels were （431.26±50.19） and （549.92±55.27） ng/L， respectively， with statistically significant differences （t=8.35， P<0.001； t=10.05， P<0.001）， and the levels of serum CEA and VEGF in the two groups after treatment were lower than before treatment （t=32.47， P<0.001； t=21.73， P<0.001； t=88.65， P<0.001； t=58.27， P<0.001）. Survival analysis showed that the median progression-free survival （PFS） of the monotherapy group and the combination group were 4.12 and 6.06 months， respectively， with a statistically significant difference （χ2=17.70， P<0.001）， the median overall survival （OS） were 11.8 and 12.7 months， respectively， with no statistically significant difference （χ2=3.09， P=0.079）. Before treatment， the FACT-L scores of patients in combination group and monotherapy group were 61.20±6.98 and 60.52±7.14， respectively， with no statistically significant difference （t=0.43， P=0.668）. After treatment， the FACT-L scores of the two groups were 83.24±9.38 and 74.58±7.86， respectively， with a statistically significant difference （t=4.48， P<0.001）， and the FACT-L scores of the two groups after treatment were all higher than before treatment （t=29.36， P<0.001； t=21.51， P<0.001）. During treatment， the total incidence of drug-related adverse reactions in two groups was 42.50% （17/40） and 55.00% （22/40）， respectively， with no statistically significant difference （χ2=1.25， P=0.263）. Conclusions Atezolizumab combined with anlotinib in the treatment of advanced NSCLC can enhance the short-term efficacy， prolong the PFS of patients， improve the quality of life， and the related adverse reactions are tolerable. Figures and Tables | References | Related Articles | Metrics

Correlation between serum levels of HAMP， SPP1， RGS2 and clinical pathological characteristics of gastric cancer patients and their predictive value for postoperative recurrence or metastasis Li Guangxin, Quan Huijuan, Gao Zhijuan, Wang Xiaojun, Li Liang, Dong Qian, Miao Yongtao, Liu Dongsheng 2025, 52 (8):  502-507.  doi: 10.3760/cma.j.cn371439-20240927-00085 Abstract ( 6 )   HTML ( 1 )   PDF (1104KB) ( 0 )   Save Objective To explore the correlation between serum hepcidin antimicrobial peptide （HAMP）， secreted phosphoprotein 1 （SPP1）， and regulator of G protein signaling 2 （RGS2） levels and the clinical pathological characteristics of gastric cancer patients， and their predictive value for postoperative recurrence or metastasis. Methods A total of 92 gastric cancer patients treated at Handan First Hospital from March 2021 to March 2023 were selected as the gastric cancer group， and 92 healthy individuals who underwent physical examinations during the same period were selected as the control group. The serum levels of HAMP， SPP1 and RGS2 were compared between the two groups. According to the mean levels of HAMP， SPP1， and RGS2 in the serum of gastric cancer patients， they were divided into HAMP high level group and HAMP low level group， SPP1 high level group and SPP1 low level group， RGS2 high level group and RGS2 low level group. The clinicopathological characteristics of gastric cancer patients with different levels of HAMP， SPP1 and RGS2 were compared respectively. After a median follow-up of 18 months， gastric cancer patients were divided into a non-recurrence or metastasis group （n=59） and a recurrence and metastasis group （n=33） based on whether the tumor recurred or metastasized. The serum levels of HAMP， SPP1， and RGS2 were compared between the two groups of patients. The predictive value of HAMP， SPP1 and RGS2 for postoperative recurrence or metastasis in patients with gastric cancer was analyzed by using the receiver operator characteristic （ROC） curve. Results Compared with the control group， the gastric cancer group had higher levels of serum HAMP [（52.28±5.44） ng/ml vs. （31.22±4.18） ng/ml] and SPP1 [（55.96±6.43） ng/ml vs. （36.99±5.25） ng/ml] （t=29.44， P<0.001； t=21.92， P<0.001）， and lower level of RGS2 [（3.72±0.66） mg/L vs. （5.11±0.87） mg/L）] （t=12.21， P<0.001）. There were statistically significant differences in maximum tumor diameter （χ2=13.07， P<0.001； χ2=6.71， P=0.010； χ2=10.56， P=0.001）， TNM staging （χ2=7.42， P=0.006； χ2=6.36， P=0.012； χ2=5.39， P=0.020）， lymph node metastasis （χ2=23.41， P<0.001； χ2=6.52， P=0.011； χ2=13.11， P<0.001）， and differentiation degree （χ2=9.01， P=0.003； χ2=7.97， P=0.005； χ2=15.29， P<0.001） between the gastric cancer patients in the HAMP high level group （n=44） and the HAMP low level group （n=48）， the SPP1 high level group （n=43） and the SPP1 low level group （n=49）， and the RGS2 high level group （n=50） and the RGS2 low level group （n=42）. Compared with the non-recurrence or metastatic group， the recurrence and metastatic group had higher levels of serum HAMP [（59.26±5.66） ng/ml vs. （48.37±4.28） ng/ml] and SPP1 [（62.85±6.36） ng/ml vs. （52.11±5.38） ng/ml] level （t=10.40， P<0.001； t=8.60， P<0.001）， and lower level of RGS2 [（3.01±0.48） mg/L vs. （4.12±0.69） mg/L] （t=8.19， P<0.001）. ROC curve analysis showed that the area under the curve （AUC） values of serum HAMP， SPP1， and RGS2 levels alone for predicting postoperative recurrence or metastasis in gastric cancer patients were 0.777， 0.813， and 0.778， respectively. The AUC value of the combination of the three indicators for predicting postoperative recurrence or metastasis in gastric cancer patients was 0.871. The predictive efficacy of the combination of the three indicators for predicting postoperative recurrence or metastasis in gastric cancer patients was better than that alone （Z=2.51， P=0.035； Z=2.61， P=0.032； Z=2.71， P=0.029）. Conclusions The levels of HAMP and SPP1 in the serum of gastric cancer patients increase， while the level of RGS2 decreases， and the levels of the three are related to the maximum tumor diameter， TNM staging， lymph node metastasis and differentiation degree， and their combined detection has higher predictive value for postoperative recurrence or metastasis in gastric cancer patients. Figures and Tables | References | Related Articles | Metrics

Time trend analysis of the disease burden of colorectal cancer among young and middle-aged adults in China from 1990 to 2021 Chen Jun, Tang Dandan, Zhou Yuxin, Tan Yuting, Li Honglan, Xu Qun, Xiang Yongbing 2025, 52 (8):  508-516.  doi: 10.3760/cma.j.cn371439-20250328-00086 Abstract ( 3 )   HTML ( 1 )   PDF (1554KB) ( 0 )   Save Objective To analyze the disease burden of colorectal cancer （CRC） among young and middle-aged people in China from 1990 to 2021， and to explore the influence of age， period and cohort on the incidence and mortality of CRC in young and middle-aged people of China. Methods Data on CRC in patients aged 40-59 years in China from 1990 to 2021 were extracted from the Global Burden of Disease Study 2021 （GBD 2021） database. Statistics such as incidence rate， mortality rate， disability-adjusted life years （DALY）， and their corresponding age-standardized rates were calculated to analyze the CRC incidence and mortality in different age and sex groups of young and middle-aged Chinese young people from 1990 to 2021. The Joinpoint regression model was used to analyze the CRC incidence， the mortality and the DALY rate， as well as to calculate the annual percentage change （APC） and the average annual percentage change （AAPC）. The effects of three independent factors， namely age， period and cohort， on the incidence and mortality of CRC in young and middle-aged people of China were analyzed and evaluated through the age-period-cohort model. Results From 1990 to 2021， there was a remarkable upward trend in the incidence， mortality， and DALY of CRC among Chinese young and middle-aged adults. In 2021， the number of incidence cases of CRC among young and middle-aged people in China reached 181 000， and the number of deaths reached 57 900， which were 236.80% and 75.48% higher than those in 1990 （53 800 and 33 000， respectively）. During the same period， DALY increased by 62.59%， with the 55-59 age group having the largest increase at 83.35%. From 1990 to 2021， the age-standardized incidence rate （ASIR） increased by 49.04%， rising from 25.51/100 000 to 38.02/100 000， and the age-standardized mortality rate （ASMR） declined by 28.75%， decreasing from 17.01/100 000 to 12.12/100 000， respectively. The increase in ASIR was the greatest among the 40-44 age group， reaching 57.31%， while the decline in ASMR was the most significant among the 50-54 age group， amounting to 30.18%. However， the DALY rate declined by 26.66%， from 673.52/100 000 to 493.94/100 000. The decline in DALY was the greatest among the 50-54 age group， reaching 28.26%. Joinpoint regression model analysis showed that， from 1990 to 2021， the incidence of CRC in Chinese young and middle-aged adults rose on average by 1.32% annually， and the increase was higher in men （1.87%） than that in women （0.36%）. The mortality rate showed a downward trend， with an average annual decline of 1.10%， with a higher decline in women than in men （-2.14% vs. -0.50%）. The DALY rate showed a downward trend， with an average annual decline of 1.00%， and more decline in women than in men （-2.06% vs. -0.41%）. All of these trends were statistically significant （all P<0.001）. The age-period-cohort model analysis showed that， the net drift of CRC incidence was 1.21% （1.02%-1.41%） per year among Chinese young and middle-aged adults between 1990 and 2021， while the net drift in mortality was -1.40% （-1.59%--1.21%） per year. The impact of age on CRC incidence and mortality intensified with advancing age. Incidence attributable to age rose from 12.66% （11.90%- 13.46%） in the 40-44 age group to 56.68% （54.37%-59.08%） in the 55-59 age group. Similarly， mortality attributable to age increased from 6.47% （6.12%-6.85%） in the 40-44 age group to 25.74% （24.58%-26.96%） in the 55-59 age group. In all age groups， the role of CRC incidence and mortality attributable to age was higher in men than in women. Period effects on the RR value of CRC incidence showed a declining trend followed by an upward trend， with the highest risk during 2015-2019 （RR=1.36， 95%CI： 1.28-1.43）， using 2000-2004 as the reference. For mortality， period effects exhibited a declining trend， with the highest risk during 1990-1994 （RR=1.23， 95%CI： 1.15-1.32）， using 2000-2004 as the reference. Cohort effects indicated that later birth cohorts had higher incidence risks， with the highest incidence observed in the 1973-1977 birth cohort （RR=1.30， 95%CI： 1.16-1.45）， using the 1953-1957 birth cohort as the reference. Conversely， later birth cohorts had lower mortality risks， with the lowest mortality in the 1973-1977 birth cohort （RR=0.78， 95%CI： 0.69-0.88）， using the 1953-1957 birth cohort as the reference. Conclusions From 1990 to 2021， the changes in the disease burden of CRC among young and middle-aged people in China are manifested as an increase in standardized incidence rate and a decrease in standardized mortality rate. Meanwhile， there are gender differences in the trend of temporal changes. Age， period and cohort all have a significant impact on the incidence and mortality trends of colorectal cancer in young and middle-aged people. Research on the etiology of CRC should be strengthened， and targeted prevention and control strategies should be formulated. Figures and Tables | References | Related Articles | Metrics

Prediction model for post-TACE infection risk in elderly patients with liver cancer Huang Jinfa, Zheng Lianqiu, Wu Jinpiao, Liu Deting, Chen Huiling 2025, 52 (8):  517-522.  doi: 10.3760/cma.j.cn371439-20240528-00087 Abstract ( 3 )   HTML ( 1 )   PDF (1582KB) ( 0 )   Save Objective To establish a risk prediction model based on least absolute shrinkage and selection operator （LASSO） regression for procalcitonin （PCT）， milk fat globule-epidermal growth factor 8 （MFG-E8） and CXC chemokine ligand 9 （CXCL9） in elderly patients with liver cancer after transcatheter arterial chemoembolization （TACE）. Methods A total of 150 elderly patients with liver cancer who underwent TACE treatment in Shishi City Hospital， Fujian Province and 910th Hospital of the Chinese People's Liberation Army Joint Logistic Support Force from August 2020 to August 2023 were selected as the study subjects. Patients with infection after TACE were included in the infected group and those without infection were included in the non-infected group according to whether the patients had infection during the postoperative hospitalization. The baseline data of patients were collected and compared. LASSO regression was used to screen the factors that may affect the infection after TACE in elderly patients with liver cancer and binary logistic regression analysis was performed. According to the results of regression analysis， a nomogram model was constructed based on the regression analysis results and the nomogram was internally validated using Bootstrap and receiver operator characteristic （ROC） curves. Results There were 18 cases of infection in 150 elderly patients with liver cancer after TACE， with an incidence of 12.00%. There were statistically significant differences in focal rupture and bleeding （χ2=5.92， P=0.015）， ascites （χ2=6.70， P=0.010）， skin or mucosal damage （χ2=6.67， P=0.010） between the infected group （n=18） and the non-infected group （n=132）. The levels of serum PCT [（1.17±0.32 ） μg/L vs. （0.91±0.14） μg/L]， MFG-E8 [（194.29±45.85） pg/ml vs. （158.76±28.63） pg/ml] and CXCL9 [（948.49±52.38） pg/ml vs. （886.05±50.07） pg/ml] were higher than those in the non-infected group， with statistically significant differences （t=4.13， P<0.001； t=4.55， P<0.001； t=4.94， P<0.001）. Four factors related to infection after TACE intervention in patients with liver cancer were finally selected by LASSO regression model， skin or mucosal damage， PCT， MFG-E8， CXCL9 levels. Binary logistic regression analysis showed that skin or mucosal damage （OR=13.48， 95%CI： 1.29-140.47， P=0.030）， high levels of serum PCT （OR=1.13， 95%CI： 1.05-1.22， P=0.001）， MFG-E8 （OR=1.04， 95%CI： 1.01-1.07， P=0.003）， CXCL9 （OR=1.05， 95%CI： 1.02-1.08， P=0.001） were risk factors for infection after TACE in elderly patients with liver cancer. Based on skin or mucosa damage， PCT， MFG-E8 and CXCL9， a nomogram prediction model for postoperative infection in elderly patients with liver cancer after TACE intervention was established. Calibration curve showed that the C-index of postoperative infection predicted by the nomogram model in elderly patients with liver cancer after TACE intervention was 0.939， indicating the model had good discrimination. ROC curve analysis showed that the area under the curve （AUC） predicted by the nomogram model for infection after TACE intervention in elderly patients with liver cancer was 0.960 （95%CI： 0.926-0.995， P<0.001）， which had certain predictive value. The specificity， sensitivity and Youden index were 0.864， 0.944 and 0.808， respectively. Conclusions Skin or mucosal damage， high levels of serum PCT， CXCL9 and MFG-E8 are closely related to postoperative infection in elderly patients with liver cancer after TACE， and the prediction model constructed based on this has better predictive performance for postoperative infection. Figures and Tables | References | Related Articles | Metrics

Review

Clinical applications of TCR sequencing in cancer immunotherapy Wu Xuehui, Li Song, Liu Lian 2025, 52 (8):  523-527.  doi: 10.3760/cma.j.cn371439-20250312-00088 Abstract ( 3 )   HTML ( 1 )   PDF (912KB) ( 0 )   Save T cell receptor （TCR） is a key molecule mediating anti-tumor immunity， and its diversity profile （TCR repertoire） serves as a biomarker of host immune status. The development of high-throughput sequencing technologies has revolutionized the application of TCR repertoire analysis in cancer immunotherapy. The clinical value of TCR sequencing in individualized tumor treatment is increasingly prominent. Through monitoring immunotherapy response and predicting survival outcomes， TCR sequencing provides critical guidance for precision tumor therapy. References | Related Articles | Metrics

Novel therapeutic strategies： targeting cancer metastasis Zhang Baihong, Yue Hongyun 2025, 52 (8):  528-531.  doi: 10.3760/cma.j.cn371439-20240811-00089 Abstract ( 3 )   HTML ( 2 )   PDF (886KB) ( 0 )   Save Tumor-related death is often associated with tumor metastasis. Metastasis process includes the acquisition of dissemination traits of tumor cells， dormancy awakening， and distant growth. Changing dissemination traits of cancer cells， maintaining and killing dormant tumor cells， editing pre-metastatic microenvironment， and reprogramming hallmarks of cancer will be key to block tumor metastasis. Bevacizumab， denosumab and cilengitide have been approved for clinical therapies. Tumor screening based on blood tests combined with artificial intelligence will provide new targeted metastasis strategies for clinical treatment. References | Related Articles | Metrics

Research progress of RNA m6A modification in breast cancer Guo Junlong, Zou Ruiqi, Chen Shaoqiang, Liang Yuxin, Li Jing, Yong Sunan, He Yuting, Xie Xiaobing, Li Ping 2025, 52 (8):  532-537.  doi: 10.3760/cma.j.cn371439-20241203-00090 Abstract ( 3 )   HTML ( 1 )   PDF (933KB) ( 0 )   Save Breast cancer is one of the most common malignant tumors among women worldwide， with an increasing incidence rate year by year， making it a significant public health concern. With the continuous advancement of tumor biology research， N6-methyladenosine （m6A） modification， as an important form of RNA modification， has attracted growing attention. The m6A modification， the most prevalent RNA modification in eukaryotes， occurs in almost all types of RNA and plays a critical role in the occurrence， progression， and metastasis of breast cancer. It influences cell proliferation， apoptosis， and alterations in the tumor microenvironment， though the specific mechanisms underlying these effects require further in-depth investigation. Moreover， the specific patterns of m6A modification demonstrate its potential as a novel biomarker for breast cancer， which could provide new directions for early diagnosis and prognosis evaluation. Figures and Tables | References | Related Articles | Metrics

Research progress of KRASG12C inhibitors in the treatment of advanced colorectal cancer Wu Xin, Ren Haipeng 2025, 52 (8):  538-542.  doi: 10.3760/cma.j.cn371439-20250225-00091 Abstract ( 2 )   HTML ( 2 )   PDF (919KB) ( 0 )   Save Colorectal cancer （CRC） remains a leading cause of cancer mortality globally. Mutations of the KRAS gene occur in 30%-40% of metastatic colorectal cancer patients， contributing to resistance to anti-epidermal growth factor receptor therapy and poor prognosis. Targeted therapy for KRAS has always been a research hotspot. In recent years， KRASG12C mutation inhibitors have achieved good efficacy in the treatment of solid tumors. KRASG12C inhibitors can be used as monotherapies and in combination with other targeted inhibitors for metastatic KRASG12C-mutant colorectal cancer. Analyzing the research progress of KRASG12C inhibitors in CRC is of great significance and can provide reference for guiding the treatment of advanced CRC. References | Related Articles | Metrics