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Journal of International Oncology    2026, 53 (1): 1-15.   DOI: 10.3760/cma.j.cn371439-20251228-00001 Abstract （423）   HTML （28）    PDF（pc） （3271KB）（209）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Mechanism of immunotherapy resistance and the progress of post-resistance treatment for dMMR/MSI-H metastatic colorectal cancer Hai Yanan, Bao Wenfang, Shentu Hangxiao, Chen Jingde Journal of International Oncology    2025, 52 (9): 598-602.   DOI: 10.3760/cma.j.cn371439-20250417-00101 Abstract （376）   HTML （8）    PDF（pc） （820KB）（56）       Knowledge map    Save Deficient mismatch repair/microsatellite instability-high （dMMR/MSI-H） metastatic colorectal cancer （CRC） is highly sensitive to immune checkpoint inhibitors due to the high tumor mutation load and neoantigen enrichment. However， 45%-60% of patients exhibit primary or acquired immunotherapy resistance. The mechanisms underlying this resistance are complex， involving tumor microenvironment heterogeneity， co-expression of multiple immune checkpoints， aberrant activation of oncogenic pathways， metabolic dysregulation， intestinal microbiota imbalance， HLA-Ⅰ molecule defects， and epigenetic regulation. Current strategies aimed at reversing immunotherapy resistance include combination immunotherapies， personalized neoantigen vaccines， intestinal microbiota transplantation， epigenetic interventions， and adoptive immune cell therapies. Further analysis of the potential mechanisms of immune therapy resistance in dMMR/MSI-H metastatic CRC， and the exploration of current strategies to overcome resistance can provide a theoretical basis for reversing the immunotherapy resistance in such patients. Reference | Related Articles | Metrics | Comments（0）

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Effects of lncRNA CASC19 on proliferation，migration and invasion of breast cancer cells by regulating miR-410-3p/LAMC1 signaling pathway Li Yao, Tian Lin, Liu Haolin, Xiao Jing Journal of International Oncology    2026, 53 (3): 129-136.   DOI: 10.3760/cma.j.cn371439-20250530-00021 Abstract （310）   HTML （18）    PDF（pc） （2163KB）（51）       Knowledge map    Save Objective To investigate the effects of long non-coding RNA （lncRNA） cancer susceptibility candidate 19 （CASC19） on the proliferation，migration and invasion of breast cancer cells by regulating the microRNA-410-3p （miR-410-3p）/laminin γ1 （LAMC1） signaling pathway. Methods A total of 53 pairs of breast cancer tissues and adjacent tissues of patients treated at Shiyan Renmin Hospital of Hubei Province from January 2023 to January 2024 were collected. The breast cancer MCF-7 cells were divided into the NC group，the sh-NC group，the sh-CASC19 group，the sh-CASC19+anti-NC group，and the sh-CASC19+anti-miR-410-3p group. The interaction between CASC19 and miR-410-3p，and between miR-410-3p and LAMC1 were verified by dual-luciferase reporter gene assay. The expression levels of CASC19，miR-410-3p and LAMC1 mRNA of MCF-7 cells in breast cancer tissues and adjacent tissues and in each group were detected by quantitative real-time PCR，cell proliferation was measured by EdU staining and CCK-8 assay，cell migration ability was evaluated by scratch assay，cell invasion ability was determined by Transwell assay，Western blotting was applied to detect the expression of proliferating cell nuclear antigen （PCNA），LAMC1，and matrix metalloproteinase-2 （MMP-2） proteins. Results The relative expression levels of CASC19 in adjacent tissues and breast cancer tissues were 1.01±0.30 and 1.65±0.31，respectively，miR-410-3p were 0.99±0.17 and 0.53±0.15，respectively，and LAMC1 were 1.00±0.29 and 1.48±0.31，respectively，with statistically significant differences （t=37.92，P<0.001； t=37.87，P<0.001； t=21.24，P<0.001）. The results of the dual-luciferase reporter gene assay showed that，CASC19 could target and negatively regulate miR-410-3p，and miR-410-3p could target and negatively regulate LAMC1. The relative expression levels of CASC19 in breast cancer MCF-7 cells from the NC，sh-NC，sh-CASC19，sh-CASC19+anti-NC，and sh-CASC19+anti-miR-410-3p groups were 1.01±0.16，0.96±0.16，0.37±0.13，0.34±0.11，0.35±0.11，respectively，miR-410-3p were 1.00±0.33，1.07±0.34，1.92±0.38，1.88±0.39，1.34±0.37，respectively，and LAMC1 mRNA were 1.00±0.17，1.05±0.17，0.44±0.13，0.41±0.13，0.89±0.15，respectively，with statistically significant differences （F=39.05，P<0.001； F=8.72，P<0.001； F=25.21，P<0.001）. Compared with the NC and sh-NC groups，the expression of CASC19 in the sh-CASC19，sh-CASC19+anti-NC，and sh-CASC19+anti-miR-410-3p groups decreased significantly （all P<0.05），the expression of miR-410-3p in sh-CASC19 group and sh-CASC19+anti-NC group increased significantly，while the expression of LAMC1 mRNA decreased significantly （all P<0.05）. Compared with the sh-CASC19 and sh-CASC19+anti-NC groups，the expression of miR-410-3p in the sh-CASC19+anti-miR-410-3p group decreased significantly，while the expression of LAMC1 increased significantly （all P<0.05）. The EdU-positive cell rates in the five groups were （45.93±5.04）%，（46.07±5.13）%，（19.26±3.25）%，（20.43±3.36）%，（37.85±4.86）%，respectively，the cell viability values were （100.00±0.00）%，（97.26±9.87）%，（46.27±7.12）%，（47.23±7.08）%，and （86.39±9.05）%，respectively，with statistically significant differences （F=54.34，P<0.001； F=76.76，P<0.001）. The scratch healing rates were （47.85±4.90）%，（48.03±4.87）%，（23.97±3.51）%，（23.42±3.26）%，and （39.54±4.12）%，respectively，the numbers of invasion were 114.62±10.98，113.78±11.87，64.53±9.41，65.14±9.04，97.86±10.27，respectively，with statistically significant differences （F=51.26，P<0.001； F=34.81，P<0.001）. The protein expression levels of PCNA were 1.14±0.14，1.17±0.15，0.34±0.10，0.36±0.11，0.93±0.13，respectively，LAMC1 were 1.37±0.15，1.32±0.14，0.59±0.09，0.61±0.09，and 1.18±0.12，respectively，MMP-2 were 0.93±0.13，0.88±0.10，0.23±0.07，0.25±0.08，0.76±0.10，respectively，with statistically significant differences （F=62.32，P<0.001； F=58.94，P<0.001； F=73.41，P<0.001）. Compared with the NC and sh-NC groups，the EdU-positive cell rate，cell viability value，scratch healing rate，number of invasion，and protein expression levels of PCNA，LAMC1，and MMP-2 in the sh-CASC19 and sh-CASC19+anti-NC groups decreased significantly （all P<0.05）. Compared with the sh-CASC19 and sh-CASC19+anti-NC groups，these indices in the sh-CASC19+anti-miR-410-3p group increased significantly （all P<0.05）. Conclusions lncRNA CASC19 may promote the proliferation，migration，and invasion of breast cancer cells by regulating the miR-410-3p/LAMC1 signaling pathway. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Chinese expert consensus on the clinical management of cancer-related neuropathic pain Chinese Society of Clinical Oncology-Supportive Care and Rehabilitation Committee Journal of International Oncology    2026, 53 (5): 257-267.   DOI: 10.3760/cma.j.cn371439-20260118-00043 Abstract （285）   HTML （16）    PDF（pc） （1153KB）（115）       Knowledge map    Save Cancer-related neuropathic pain （CRNP） is a common type of pain among cancer patients， significantly impacting their quality of life. To standardize the clinical management of CRNP， the Chinese Society of Clinical Oncology-Supportive Care and Rehabilitation Committee organized experts from related fields to develop this consensus based on the GRADE evidence grading system. The consensus clarifies the definition and etiological classification of CRNP （cancer-induced， anticancer treatment-induced， and oncology multimorbidity-related）， systematically elaborates on the screening， diagnosis， and assessment processes of CRNP， recommends the use of scales such as DN4 and LANSS for screening， and confirms the diagnosis based on the NeuPSIG grading system. In terms of treatment， the consensus recommends selecting first-line drugs such as calcium channel modulators， tricyclic antidepressants， and serotonin-norepinephrine reuptake inhibitors based on the etiology， and emphasizes multimodal interventions such as combination therapy， local therapy， minimally invasive intervention， and physical therapy. Additionally， priority should be given to comprehensive patient education， evidence-informed psychological support， integration of traditional medicine and structured long-term follow-up management. This consensus provides evidence-based basis and practical guidance for the individualized and multidisciplinary comprehensive management of CRNP. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Prognostic analysis of different surgical approaches in elderly patients with advanced ovarian cancer Qiu Kexin, Li Mengzhen, Guo Haoran, Fan Mengsi, Yan Li Journal of International Oncology    2025, 52 (9): 576-582.   DOI: 10.3760/cma.j.cn371439-20250225-00097 Abstract （265）   HTML （11）    PDF（pc） （1335KB）（40）       Knowledge map    Save Objective To investigate the differences in prognosis between different surgical approaches in elderly patients with advanced ovarian cancer. Methods Based on the Surveillance， Epidemiology and End Results （SEER） database， a cohort of elderly patients with advanced ovarian cancer from 2000 to 2020 was established. Through propensity score matching， 2 094 patients were selected from those who underwent two different surgical approaches to form a matched cohort （SEER database cohort）， including 1 039 patients who received cytoreductive surgery and 1 055 patients who underwent local resection. Meanwhile， 148 elderly patients with advanced ovarian cancer who were treated at the First Affiliated Hospital of Shandong First Medical University from January 2012 to January 2024 were selected （hospital cohort）， among whom 85 underwent cytoreductive surgery and 63 underwent local resection. The prognostic differences among patients who underwent cytoreductive surgery and local resection in two cohorts and stratified by the International Federation of Gynecology and Obstetrics （FIGO） staging were evaluated， respectively. The relationship between the causes of death and surgical approaches in elderly patients with advanced ovarian cancer was analyzed. Results In the SEER database cohort， the median overall survival （OS） for patients who underwent cytoreductive surgery and local resection was 37 and 40 months， respectively， with 5-year OS rates of 31.47% and 33.74%， with no statistically significant difference （χ2=0.78， P=0.378）. After stratification by FIGO staging， the median OS for patients with stage ⅢB-ⅢC who underwent cytoreductive surgery （n=998） and local resection （n=962） was 38 and 40 months， respectively， with no statistically significant difference （χ2=0.20， P=0.659）. For patients with stage Ⅳ， the median OS for those who underwent cytoreductive surgery （n=41） and local resection （n=93） was 17 and 36 months， respectively， with a statistically significant difference （χ2=9.37， P=0.002）. Among 2 094 elderly patients with advanced ovarian cancer， 1 581 had clearly identified causes of death. In patients who underwent cytoreductive surgery， the proportions of deaths due to ovarian cancer and non-ovarian cancer were 94.52% （742/785） and 5.48% （43/785）， respectively. In patients who underwent local resection， the proportions of deaths due to ovarian cancer and non-ovarian cancer were 91.46% （728/796） and 8.54% （68/796）， respectively. There was a statistically significant difference in the distribution of causes of death between the two surgical approaches （χ2=5.69， P=0.017）. In the hospital cohort， the median OS for patients undergoing cytoreductive surgery and local resection was 39 and 51 months， respectively， with 5-year OS rates of 22.85% and 23.81%， with a statistically significant difference （χ2=6.71， P=0.010）. After stratification by FIGO staging， the median OS for patients with stage ⅢB-ⅢC undergoing cytoreductive surgery （n=29） and local resection （n=26） was 50 and 51 months， respectively， with no statistically significant difference （χ2=0.15， P=0.699）； for patients with stage Ⅳ undergoing cytoreductive surgery （n=56） and local resection （n=37）， the median OS was 35 and 47 months， respectively， with a statistically significant difference （χ2=6.55， P=0.011）. Conclusions The survival outcomes of local resection in elderly patients with advanced ovarian cancer are not inferior to those of cytoreductive surgery. For FIGO stage Ⅳ patients， the survival period following local resection is superior to that of cytoreductive surgery. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Interpretation of the "2025 Korean Thyroid Association clinical management guideline on active surveillance for low-risk papillary thyroid carcinoma" Wang Xingyue, Liu Qinjiang Journal of International Oncology    2026, 53 (7): 398-403.   DOI: 10.3760/cma.j.cn371439-20251229-00065 Abstract （240）   HTML （2）    PDF（pc） （1479KB）（36）       Knowledge map    Save In recent years， the clinical active surveillance （AS） for low-risk papillary thyroid carcinoma has been approached with extreme caution by both domestic and international guidelines， and there has even been controversy. The "2025 Korean Thyroid Association clinical management guideline on active surveillance for low-risk papillary thyroid carcinoma" comprehensively delineate the assessment and screening of the appropriate population for AS in low-risk papillary thyroid carcinoma. The guidelines recommend clinical management protocols during AS， and outline the indications for surgical intervention during the AS period. Based on relevant domestic and international guidelines， a comparative analysis is now conducted on the characteristics of patients with AS who are suitable for treatment at the age of 19 or above， the follow-up strategy dominated by ultrasound examinations， and the timing of surgical intervention in the event of tumor progression during AS， with the aim of offering references for clinical practice. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Classification，distribution and relationship with tumors of CAF Qing Shuman, Wang Yuanyuan, Yu Shuyang, Li Yingge, Yao Yi Journal of International Oncology    2026, 53 (3): 167-173.   DOI: 10.3760/cma.j.cn371439-20250613-00027 Abstract （234）   HTML （10）    PDF（pc） （802KB）（45）       Knowledge map    Save Cancer-associated fibroblasts （CAFs） are important components in constructing tumor microenvironment and exhibit significant heterogeneity. Currently，more than ten CAFs subtypes have been identified，which can be classified into two major categories： cancer-promoting and cancer-restraining. Cancer-promoting CAFs promotes tumor progression through extracellular matrix remodeling，immune suppression，angiogenesis and metabolic reprogramming. In contrast，cancer-restraining CAFs exerts anti-tumor effects by recruiting CD8+ T cells/natural killer （NK） cells. The spatial distribution of different CAFs subtypes is closely associated with the specific microenvironment of the tumor region，and multiple subtypes can undergo dynamic transformation under specific conditions，inducing tumor treatment resistance and thereby affecting patient prognosis. Targeting the elimination of cancer-promoting CAFs subsets or inducing their transformation into cancer-restraining subtypes is a promising strategy for remodeling the tumor microenvironment，inhibiting tumor progression，and overcoming drug resistance. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Diagnostic value of multimodal Nomogram model combining 18F-FDG PET/CT and ultrasound for triple negative breast cancer Chen Qiaoliang, Qin Xinyan, Lai Ruihe, Tan Shuangxiu Journal of International Oncology    2025, 52 (9): 560-565.   DOI: 10.3760/cma.j.cn371439-20250414-00095 Abstract （232）   HTML （12）    PDF（pc） （1186KB）（61）       Knowledge map    Save Objective To evaluate the diagnostic value of multimodal Nomogram model combining 18F-FDG PET/CT and ultrasound for triple negative breast cancer （TNBC）. Methods A total of 61 breast cancer patients admitted at Nanjing Drum Tower Hospital， Affiliated Hospital of Nanjing University Medical School from November 2016 to May 2024 were selected as the study subjects， including 12 cases of TNBC and 49 cases of non-TNBC. 18F-FDG PET/CT metabolic parameters maximum standardized uptake value （SUVmax）， mean standardized uptake value （SUVmean）， minimum standardized uptake value （SUVmin）， tumor metabolic volume （MTV）， and total lesion glycolysis （TLG）， as well as the ultrasound parameters long diameter， short diameter， echogenicity， morphology， boundaries， posterior echogenicity， aspect ratio， microcalcifications， blood flow grading and Breast Imaging Reporting and Data System （BI-RADS） grading were compared between patients with and without TNBC. Least absolute shrinkage and selection operator （LASSO） regression was used for feature screening， and binary multivariate logistic regression analysis was conducted on the screened variables to obtain the independent influencing factors for diagnosing TNBC. The independent factors influencing the diagnosis of TNBC were established as Nomogram model and visualized. Receiver operator characteristic （ROC） curve， calibration curve and decision curve analysis （DCA） were used to evaluate the diagnostic efficacy， accuracy and clinical practicability of the model， respectively. Results There were statistically significant differences in SUVmax （Z=-2.43， P=0.015）， SUVmean （Z=-2.54， P=0.011）， morphology （P=0.004）， boundaries （χ2=4.86， P=0.028）， posterior echogenicity （P=0.027）， and blood flow grading （χ2=4.52， P=0.034） between TNBC and non-TNBC patients. LASSO regression screened out three variables： SUVmax， morphology and blood flow grading. Multivariate analysis showed that， SUVmax （OR=1.20， 95%CI： 1.04-1.38， P=0.012）， morphology （OR=0.02， 95%CI： 0.01-0.49， P=0.016）， and blood flow grading （OR=0.06， 95%CI： 0.01-0.74， P=0.028） were the independent influencing factors for diagnosing TNBC. A Nomogram model was established based on the above independent influencing factors. ROC curve showed that， area under the curve （AUC） of SUVmax， morphology， blood flow grading， and the Nomogram model were 0.73 （95%CI： 0.60-0.83）， 0.66 （95%CI： 0.52-0.77）， 0.67 （95%CI： 0.54-0.79）， 0.90 （95%CI： 0.79-0.96）， respectively， and the diagnostic value of the Nomogram model was higher than that of SUVmax （Z=2.71， P=0.007）， morphology （Z=3.61， P<0.001）， and blood flow grading （Z=2.51， P=0.012） alone. Calibration curve and DCA showed better accuracy and clinical practicability of the Nomogram model. Conclusions Nomogram model constructed by combining the SUVmax of 18F-FDG PET/CT with the morphology and blood flow grading of ultrasound has a promising potential for diagnosing TNBC. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Analysis of the association between plasma D-dimer levels and thromboembolic risk in patients with malignant solid tumors Lin Xueqiong, Chen Ting, Huang Xuchun, Wu Wenzhi, Peng Yuhui Journal of International Oncology    2026, 53 (2): 93-99.   DOI: 10.3760/cma.j.cn371439-20250806-00014 Abstract （231）   HTML （2）    PDF（pc） （1048KB）（14）       Knowledge map    Save Objective To evaluate the risk stratification value of plasma D-dimer （D-D） levels for venous thromboembolism （VTE） within 6 months in patients with malignant solid tumors. Methods A total of 11 082 patients with pathologically confirmed malignant solid tumors who were first treated at Cancer Hospital of Shantou University Medical College from January 2021 to December 2023 were retrospectively included， 1 222 cases among which completed imaging examinations such as vascular ultrasound， lower-limb venous ultrasound， or CT pulmonary angiography （CTPA） within 6 months. After excluding 95 cases with missing data， 1 127 patients were divided into the VTE group （n=338） and the non-VTE group （n=789） based on the VET diagnosis results. Gender， age， tumor location， baseline D-D measured at first visit （D-D1）， and D-D obtained on or the day before imaging （D-D2） were compared between the two groups. Multivariate logistic regression was used to analyze the independent association between plasma D-D levels and VTE. Based on the results of the multivariate analysis， the “boot” package in R was employed to perform 1 000 Bootstrap resampling iterations. In each iteration， 70% of the samples were randomly selected as the training set for constructing the prediction model， while the remaining 30% served as the validation set. Logistic regression was adopted for model construction， and a nomogram was generated using the R package “nomogram”. The receiver operator characteristic （ROC） curve was constructed to evaluate its diagnostic efficacy. Results There was a statistically significant difference in D-D1 levels between patients of different genders （Z=-5.83， P<0.001）. There were statistically significant differences in the levels of D-D1 and D-D2 in patients of different ages （χ2=585.52， P<0.001； χ2=58.56， P<0.001） and different tumor locations （χ2=1 051.12， P<0.001；χ2=227.64， P<0.001）. There were statistically significant differences in age and tumor location between the VTE group and the non-VTE group （t=-3.70， P<0.001； χ2=3 431.24， P<0.001）. The levels of D-D1 and D-D2 were significantly higher in the VTE group than those in the non-VTE group （Z=9.80， P<0.001； Z=17.12， P<0.001）. Multivariate analysis demonstrated that gender （female：OR=1.87， 95%CI：1.20-2.90， P=0.006）， age （61-70 years old：OR=0.56， 95%CI：0.32-0.98， P=0.042）， tumor location （esophagus：OR=0.30， 95%CI：0.14-0.67， P=0.003； gastrointestinal tract：OR=0.31， 95%CI：0.15-0.68， P=0.003； breast：OR=0.15， 95%CI：0.07-0.33， P<0.001； urinary tract：OR=0.33， 95%CI：0.13-0.86， P=0.023）， and D-D2 levels [551-1 100 μg/L fibrinogen equivalent units （FEU） （OR=2.55， 95%CI：1.31-4.99， P=0.006）， 1 101-4 000 μg/L FEU （OR=9.17， 95%CI：5.06-16.61， P<0.001）， and ≥4 001 μg/L FEU （OR=21.09， 95%CI：11.38-39.08， P<0.001）] were independent influencing factors for VTE in patients with malignant solid tumors. The risk of VTE increased with rising D-D2 levels. A multivariate nomogram was constructed to predict the risk of VET occurrence in patients with malignant solid tumors based on gender， age， tumor location， and D-D2 level. A D-D2 four-tier nomogram was constructed to predict the risk of VET occurrence in patients with malignant solid tumors based on the D-D2 four-tier stratification. ROC curve analysis showed that in the training set， the area under the curve （AUC） of the multivariate nomogram model for predicting VET in patients with malignant solid tumors was 0.828 （95%CI：0.798-0.858）， while the AUC of the D-D2 four‑stratification model （using 1 101-4 000 μg/L FEU as the optimal cutoff interval） was 0.811 （95%CI：0.781-0.840）. The predictive performance of the multivariate model was superior to that of the D-D2 four‑stratification model （Z=3.74， P<0.001）. In the test set， the AUC of the multivariate nomogram model for predicting VET in patients with malignant solid tumors was 0.814 （95%CI：0.763-0.864）， and that of the D-D2 four-stratification model was 0.787 （95%CI：0.733-0.841）， with no statistically significant difference （Z= 1.90， P=0.057）. Conclusions Elevated D-D is an independent risk factor for VTE within 6 months in malignant solid tumor patients. A threshold of ≥4 001 µg/L FEU can trigger intensive thrombotic work-up， facilitating early identification of high-risk patients and improving prognosis. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Mechanism of the cGAS-STING signaling pathway in non-small cell lung cancer and its targeted therapeutic strategies Che Gen, Wu Rihan, Zhu Tiantian, Dong Li Journal of International Oncology    2025, 52 (9): 587-591.   DOI: 10.3760/cma.j.cn371439-20250415-00099 Abstract （226）   HTML （6）    PDF（pc） （806KB）（33）       Knowledge map    Save The treatment of non-small cell lung cancer （NSCLC） faces significant challenges due to tumor heterogeneity and the complexity of the immune microenvironment. The cyclic GMP-AMP synthase （cGAS）-stimulator of interferon gene （STING） signaling pathway plays a dual role in NSCLC， serving both as a crucial hub for anti-tumor immunity and as a potential driver of metastasis. The clinical translation of STING agonists confronts a series of challenges， including delivery barriers， double-edged sword effects， and patient heterogeneity. Consequently， exploring the combined application of STING agonists with radiotherapy/chemotherapy， immune checkpoint inhibitors， and novel immunotherapies， alongside leveraging artificial intelligence-driven multi-omics models for individualized prediction and treatment， holds significant importance. A deeper understanding of the molecular regulatory network of the cGAS-STING signaling pathway and its dynamic functions within the tumor microenvironment is essential for overcoming the current clinical challenges of targeted therapies and advancing the precision development of NSCLC immunotherapy strategies. Reference | Related Articles | Metrics | Comments（0）

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Mechanism of action of SHCBP1 in malignant tumors and progress in clinical research Liu Mei, Hu Yuchong, Li Fengtong, Chao Lemen, Liu Meng, Kang Linlin Journal of International Oncology    2025, 52 (9): 583-586.   DOI: 10.3760/cma.j.cn371439-20250331-00098 Abstract （225）   HTML （10）    PDF（pc） （763KB）（38）       Knowledge map    Save SHCBP1 is a type of Src homologous collagen that can specifically bind to the SH2 structural domain. It can act as a key regulatory protein， and exhibits abnormally high expression in a variety of malignant tumors. Through affecting the processes such as cell cycle， proliferation， and invasion， it participates in tumor genesis and development. In addition， high expression of SHCBP1 is closely related to chemotherapy resistance and poor prognosis of many malignant tumors， and its targeted inhibition can enhance the sensitivity of chemotherapy and provide new therapeutic strategies for a variety of solid tumors， making it an important biomarker for prognostic assessment and a potential therapeutic target. Reference | Related Articles | Metrics | Comments（0）

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Research on positioning errors analysis of gamma knife pain-free face mask fractionated treatment for head tumors based on kV orthogonal image guidance Li Peng, Zhang Shuang, Liu Huafeng, Ji Na, Hou Xiangkun, Xi Aohang, Zong Jianhai Journal of International Oncology    2025, 52 (9): 554-559.   DOI: 10.3760/cma.j.cn371439-20250530-00094 Abstract （210）   HTML （8）    PDF（pc） （1463KB）（24）       Knowledge map    Save Objective To analyze the positioning error and the overall setup errors （OSEs） of patients undergoing gamma knife pain-free face mask fractionated treatment for head tumors based on kV orthogonal image guidance. Methods A total of 58 patients who received image-guided fractionated gamma knife treatment for head tumors with a pain-free face mask at the Gamma Knife Treatment Center of Xi'an International Medical Center Hospital from July 1， 2022 to May 31， 2024 were included in the study. A kV-class orthogonal X-ray IGPS image-guided positioning system was used to collect positioning errors in three translational directions： left-right （X）， anterior-posterior （Y）， and head-foot （Z）， as well as in three rotational directions： left-right （P）， anterior-posterior （R）， and head-foot （Y） before correction. After online correction and combined with manual positioning verification， the corrected positioning errors were recalculated. The OSEs in translational and rotational directions were calculated before and after correction. The positioning errors in all six directions （X， Y， Z， P， R， Y） before and after correction were plotted. And the OSE scatter plots in translational and rotational directions were created accordingly. Errors in the six directions and OSEs in translational and rotational directions were compared. The OSEs in translational and rotational directions were analyzed across different age groups and genders. Results The pre-correction positioning errors in the X， Y， Z， P， R， Y directions for patients were （0.45±1.54） mm， -0.96 （-1.70， -0.28） mm， 1.67 （-0.15， 3.07） mm， （0.70±1.60）°， 0.65 （0.30， 1.19）°， （0.59±0.87）°， and the post-correction positioning errors were （-0.02±0.18） mm， 0.15 （0.10， 0.21） mm， 0.06 （-0.04， 0.16） mm， （0.20±0.79）°， 0.42 （0.19， 0.78）°， （0.20±0.63）°. There were statistically significant differences between before and after correction （t=2.30， P=0.025； Z=-5.43， P<0.001； Z=-4.10， P<0.001； t=2.56， P=0.013； Z=-3.21， P=0.001； t=3.21， P=0.002）. The OSEs in translational （X， Y， Z） and rotational （P， R， Y） directions before correction were 3.07 （1.93， 4.35） mm， 1.90 （1.28， 2.66）°， and the OSEs after correction were 0.27 （0.21， 0.33） mm， 1.08 （0.70， 1.54）°， with statistically significant differences （Z=-6.60， P<0.001； Z=-5.52， P<0.001）. For patients aged 18-44 years， the OSEs in translational （X， Y， Z） and rotational （P， R， Y） directions before and after correction were 3.65 （1.62， 3.95）， 0.21 （0.21， 0.31） mm， 3.25 （2.24， 3.96）°， 0.92 （0.59， 1.45）°； for patients aged 45-59 years， the OSEs were 3.57 （2.17， 5.22）， 0.29 （0.22， 0.35） mm， 1.89 （1.30， 2.30）°， 1.08 （0.62， 1.51）°； for patients aged 60-74 years， the OSEs were 2.92 （1.74， 4.06）， 0.24 （0.19， 0.35） mm， 2.16 （1.09， 2.95）°， 0.98 （0.78， 1.75）°； for patients aged 75-89 years， the OSEs were 3.24 （2.12， 4.37）， 0.29 （0.22， 0.47） mm， 1.73 （1.01， 1.83）°， 0.60 （0.47， 1.51）°. There were no statistically significant differences in OSEs of translational and rotational directions before and after correction among the four age groups （H=1.23， P=0.747； H=1.74， P=0.627； H=7.45， P=0.059； H=2.80， P=0.424）. For male patients， the OSEs before and after correction in translational （X， Y， Z） and rotational （P， R， Y） directions were （3.19±1.59）， 0.27 （0.27， 0.33） mm， 1.89 （1.27， 2.75）°， （0.84±0.59）°； for female patients， the OSEs were （3.22±1.99）， 0.26 （0.25， 0.35） mm， 1.90 （1.34， 2.41）°， （1.04±0.46）°. There were no statistically significant differences in OSEs of translational and rotational directions before and after correction between genders （t=-0.07， P=0.949； Z=-0.48， P=0.632； Z=-0.02， P=0.161； t=-2.80， P=0.424）. Conclusions The image-guided system， which is based on the kV orthogonal X-ray stereoscopic imaging， can significantly reduce the positioning errors between fractions of pain-free face mask gamma knife treatment for head tumor patients and improve the positioning accuracy of the gamma knife through the dual verification process of "automatic correction and manual review". Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Prospective cohort study on the effect of abdominal circumference on the intestinal radiation dose volume and the acute intestinal toxicity in pelvic intensity modulated radiation therapy for rectal cancer patients Wu Songyou, Wang Gang, Wang Wenling, Dong Hongmin, Chen Weiwei, Li Xiaokai, Chen Wanghua, Zuo Kai Journal of International Oncology    2025, 52 (9): 566-575.   DOI: 10.3760/cma.j.cn371439-20250417-00096 Abstract （207）   HTML （8）    PDF（pc） （1235KB）（184）       Knowledge map    Save Objective To investigate the effect of abdominal circumference on intestinal radiation dose volume and acute intestinal toxicity in pelvic intensity modulated radiation therapy for rectal cancer. Methods A total of 150 patients with locally advanced rectal cancer （LARC） who received adjuvant and neoadjuvant concurrent chemoradiotherapy at the Affiliated Cancer Hospital of Guizhou Medical University from March 2023 to January 2025 were enrolled， including 82 cases of adjuvant radiotherapy and 68 cases of neoadjuvant radiotherapy. All patients underwent radiotherapy CT simulation positioning in the standard mode of prone position with abdominal board padding and bladder filling. Intestinal toxicity was categorized as a binary variable based on the occurrence of ≥2 grade acute intestinal toxicity. Linear and logistic regression models were used to analyze the factors influencing intestinal radiation dose volumes （V10， V20， V30， V40） and acute intestinal toxicity in LARC patients. Generalized additive models and piecewise linear and logistic regression analyses were employed to examine the threshold effects of abdominal circumference on intestinal radiation dose volumes and acute intestinal toxicity. The threshold value for abdominal circumference was determined based on the upper limit of the 95%CI for the threshold. A difference test was used to validate the differences in intestinal radiation dose volume and acute intestinal toxicity between small and medium-to-large abdominal circumferences. Results Univariate analysis showed that， gender， body mass， abdominal circumference， planning target volume （PTV）， intestinal volume were all influencing factors for the radiation dose volumes （V10， V20， V30， V40） of each intestinal segment of patients with LARC undergoing adjuvant radiotherapy （all P<0.05）. Body mass， abdominal circumference， intestinal volume were all influencing factors for the radiation dose volumes （V10， V20， V30， V40） of each intestinal segment of patients with LARC undergoing neoadjuvant radiotherapy （all P<0.05）. Body mass index （BMI）， abdominal circumference， intestinal volume and individual intestinal radiation volumes （V10， V20， V30， V40） were all influencing factors for the acute intestinal toxicity of patients with LARC undergoing adjuvant radiotherapy （all P<0.05）. Body mass， BMI， abdominal circumference， multiple intestinal radiation dose volumes（V20， V30， V40） were all influencing factors for the acute intestinal toxicity of patients with LARC undergoing neoadjuvant radiotherapy （all P<0.05）. Multivariate analysis showed that， abdominal circumference （V10： β=-1.01， 95%CI： -1.68--0.33， P=0.004； V20： β=-0.94， 95%CI： -1.28--0.60， P<0.001； V30： β=-0.58， 95%CI： -0.82--0.34， P<0.001； V40： β=-0.41， 95%CI： -0.60--0.23， P<0.001） was an independent influencing factor for the radiation dose volume of each intestinal segment of patients with LARC undergoing adjuvant radiotherapy. Abdominal circumference （V10： β=-0.92， 95%CI： -1.62--0.22， P=0.010； V20： β=-0.84， 95%CI： -1.11--0.57， P<0.001； V30： β=-0.42， 95%CI： -0.57--0.28， P<0.001； V40： β=-0.30， 95%CI： -0.41--0.19， P<0.001） was an independent influencing factor for the radiation dose volume of each intestinal segment of patients with LARC undergoing neoadjuvant radiotherapy. Abdominal circumference （OR=0.86， 95%CI： 0.78-0.95， P=0.002） was an independent influencing factor for the acute intestinal toxicity of patients with LARC undergoing adjuvant radiotherapy. Abdominal circumference （OR=0.87， 95%CI： 0.79-0.96， P=0.004） was an independent influencing factor for the acute intestinal toxicity of patients with LARC undergoing neoadjuvant radiotherapy. The generalized additive model revealed a nonlinear relationship between abdominal circumference and intestinal radiation dose volume and acute intestinal toxicity of adjuvant radiotherapy patients. Further segmented regression analysis results showed that there was a threshold effect between abdominal circumference and intestinal radiation dose volume （V10， V20， V30， V40） and acute intestinal toxicity. The inflection point values between abdominal circumference and intestinal radiation dose volume V10， V20， V30， V40 in LARC patients undergoing adjuvant radiotherapy were all 71.9 cm； the inflection point values between abdominal circumference and the intestinal radiation dose volume V10， V20， V30， V40 in LARC patients undergoing neoadjuvant radiotherapy were 69.0， 69.0， 69.0， 68.6 cm， respectively； The inflection point values between abdominal circumference and acute intestinal toxicity in LARC patients undergoing adjuvant radiotherapy and neoadjuvant radiotherapy were 71.9 ， 69.0 cm， respectively. Based on the upper limit of the 95%CI threshold， the cutoff values for small and medium-to-large abdominal circumferences for patients undergoing adjuvant and neoadjuvant radiotherapy were set at 76.1， 71.9 cm， respectively. In patients undergoing adjuvant radiotherapy， the levels of intestinal radiation dose volume V10 [（7.65±2.29） cm3 vs. （5.88±2.68） cm3， t=2.76， P=0.007]， V20 [（4.28±1.27） cm3 vs. （2.72±1.31） cm3， t=4.81， P<0.001]， V30 [（2.42±1.07） cm3 vs. （1.37±0.76） cm3， t=4.95， P<0.001]， V40 [（1.69±0.74） cm3 vs. （0.92±0.58） cm3， t=4.93， P<0.001] in the small abdominal circumference group （n=22） were significantly higher than those in patients with medium-to-large abdominal circumferences （n=60）； In patients undergoing neoadjuvant radiotherapy， patients with small abdominal circumferences （n=11） had significantly higher V20 [（3.09±0.84） cm3 vs. （2.28±1.17） cm3， t=2.17， P=0.033]， V30 [1.44 （1.22， 1.53） cm3 vs. 0.91 （0.56， 1.22） cm3， Z=-3.04， P=0.002]， V40 [0.93 （0.84， 1.09） cm3 vs. 0.44 （0.30， 0.81） cm3， Z=-3.19， P=0.001] than patients with medium-to-large abdominal circumferences （n=57）. In patients receiving adjuvant radiotherapy and neoadjuvant radiotherapy， there were statistically significant differences in acute intestinal toxicity between patients with small abdominal circumferences and with medium-to-large abdominal circumferences （χ²=10.46， P=0.001； χ²=8.13， P=0.004）. Conclusions In the standard mode （prone position with abdominal board padding and bladder filling）， abdominal circumference is an independent factor influencing the intestinal radiation dose volume and acute intestinal toxicity in rectal cancer radiotherapy patients. There is a significant non-linear threshold effect between abdominal circumference and different levels of intestinal radiation dose volume and acute intestinal toxicity. The impact of abdominal circumference on intestinal radiation dose volume and toxicity differs significantly before and after the inflection point value. Patients with smaller abdominal circumferences not only fail to achieve the expected benefits under the current standard radiotherapy regimen but also face higher risks of intestinal radiation dose volume and toxicity. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Analysis of factors influencing the prognosis of patients with postoperative peritoneal metastasis of gastric cancer Liu Pingping, Wang Junyi, Lin Zhiwei, Chen Dachao Journal of International Oncology    2025, 52 (12): 764-769.   DOI: 10.3760/cma.j.cn371439-20250509-00130 Abstract （204）   HTML （4）    PDF（pc） （1112KB）（29）       Knowledge map    Save Objective To investigate the factors influencing the prognosis of patients with postoperative peritoneal metastasis of gastric cancer. Methods The clinical data of 141 patients with postoperative peritoneal metastasis of gastric cancer admitted to the 909th Hospital （Dongnan Hospital of Xiamen University） from January 2022 to December 2023 were analyzed retrospectively. All patients were followed up for 1 year， and the clinical characteristics of patients with different outcomes were analyzed. The Cox proportional hazards regression model was used to analyze factors influencing patients' prognosis， Kaplan-Meier survival curves were plotted， and the log-rank test was employed to compare 1-year overall survival （OS） rates among patients with different influencing factors. Results Among 141 patients with peritoneal metastasis after gastric cancer surgery， 51 died. The 1-year OS rate of the patients was 70.20%， and the median OS was 13 months. There were statistically significant differences in terms of lymph node metastasis （χ2=9.17， P=0.002）， vascular invasion （χ2=11.78， P=0.001）， cancer nodules （χ2=10.04， P=0.002）， Borrmann type （χ2=6.81， P=0.009）， TNM stage （χ2=22.22， P<0.001）， systemic treatment （χ2=6.47， P=0.011）， and intraperitoneal perfusion chemotherapy （χ2=10.28， P=0.001） between deceased and surviving patients. Multivariate analysis showed that， lymph node metastasis （HR=2.15， 95%CI： 1.44-6.53， P=0.010）， vascular invasion （HR=1.98， 95%CI： 1.28-6.91， P=0.023）， cancer nodules （HR=1.98， 95%CI： 1.26-7.98， P=0.042）， TNM stage （HR=2.09， 95%CI： 1.37-8.03， P=0.025）， and intraperitoneal perfusion chemotherapy （HR=2.19， 95%CI： 1.53-6.30， P=0.008） were all factors influencing the prognosis of patients with postoperative peritoneal metastasis of gastric cancer. Survival curve analysis showed that， the 1-year OS rates of patients with and without lymph node metastasis were 50.0% and 74.7%， respectively， with a statistically significant difference （χ2=9.77， P=0.002）； the 1-year OS rates of patients with and without vascular invasion were 47.5% and 75.6%， respectively， with a statistically significant difference （χ2=12.51， P<0.001）； the 1-year OS rates of patients with and without cancer nodules were 34.8% and 69.5%， respectively， with a statistically significant difference （χ2=11.80， P=0.001）； the 1-year OS rates of patients with TNM stage Ⅰ and Ⅱ were 80.2% and 41.7%， respectively， with a statistically significant difference （χ2=20.64， P<0.001）； and the 1-year OS rates of patients without and with intraperitoneal perfusion chemotherapy were 52.5% and 78.7%， respectively， with a statistically significant difference （χ2=9.83， P=0.002）. Conclusions Lymph node metastasis， vascular invasion， cancer nodules， TNM stage Ⅱ， and no intraperitoneal perfusion chemotherapy are all risk factors for the prognosis of patients with postoperative peritoneal metastasis of gastric cancer. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Anti-tumor effect and immunomodulatory mechanism of atractylenolide Ⅱ on colon cancer mice Wang Mengju, Wang Xia Journal of International Oncology    2025, 52 (9): 545-553.   DOI: 10.3760/cma.j.cn371439-20250704-00093 Abstract （197）   HTML （14）    PDF（pc） （3772KB）（108）       Knowledge map    Save Objective To explore the anti-tumor effect of atractylenolide Ⅱ （ATL-Ⅱ） on colon cancer and its immunomodulatory mechanism. Methods A subcutaneous xenograft model of colon cancer was constructed using C57BL/6 mice. The mice were randomly divided into the model group （intraperitoneal injection of PBS）， ATL-Ⅱ low-dose （20 mg/kg） group， medium-dose （40 mg/kg） group， high-dose （60 mg/kg） group， as well as the 5-fluorouracil （5-FU 30 mg/kg） group， with 5 mice in each group， and the administration lasted for 21 days. HE staining was performed to detect the histopathological changes in the tumor tissues. The levels of expressions of Ki-67， Caspase-3， and Bcl-2 were detected by immunohistochemistry. The rates of CD8+ T and NK1.1 positive cells in tumor tissues were detected by immunofluorescence. The serum levels of granzyme B （GzmB） and interferon-λ （IFN-λ） were measured by ELISA. The levels of expressions of PD-L1 and proteins involved in the ERK/MAPK signaling pathway were analyzed by Western blotting. Results The tumor volumes of colon cancer xenograft mice in the model group， ATL -Ⅱ low-， medium-， high-dose groups and the 5-FU group were （1 845.17±65.72） ， （1 637.20±122.65）， （1 232.86±209.16）， （1 002.29±41.84）， and （911.59±294.71） mm³， respectively， with a statistically significant difference （F=125.61， P<0.001）. Compared with the model group， there were statistically significant differences in the ATL-Ⅱ low-， medium-， high-dose groups and the 5-FU group （all P<0.05）. Compared with the low-dose group， there were statistically significant differences in the ATL-Ⅱ medium-， high-dose groups and the 5-FU group （all P<0.05）， with a statistically significant difference also observed between the medium- and high-dose groups （P<0.05）. Compared with the ATL-Ⅱ medium- and high-dose groups， the 5-FU group demonstrated statistically significant differences （both P<0.05）. The mass of tumors of the five groups was （1.34±0.11）， （1.26±0.09）， （0.93±0.07）， （0.94±0.10）， and （0.59±0.08） g， respectively， with a statistically significant difference （F=88.88， P<0.001）. Compared with the model group， there were statistically significant differences in the ATL-Ⅱ medium-， high-dose groups and the 5-FU group （all P<0.05）. Compared with the low-dose group， there were statistically significant differences in the ATL-Ⅱ medium-， high-dose groups and the 5-FU group （all P<0.05）. Compared with the ATL-Ⅱ medium- and high-dose groups， there were statistically significant differences in the 5-FU group （both P<0.05）. The spleen indexes of the five groups were 7.42±0.88， 7.38±1.32， 8.42±0.78， 9.72±1.18， and 6.16±1.05， respectively， with a statistically significant difference （F=33.20， P<0.001）. Compared with the model group， there were statistically significant differences in the ATL-Ⅱ medium- and high-dose groups and the 5-FU group （all P<0.05）. Compared with the low-dose group， there were statistically significant differences in the ATL-Ⅱ medium-， high-dose groups and the 5-FU group （all P<0.05）， and the spleen index in the high-dose group was higher than that in the medium-dose group （P<0.05）. Compared with the ATL-Ⅱ medium- and high-dose groups， there were statistically significant differences in the 5-FU group （both P<0.05）. HE staining showed that， the tumor tissues of mice in the model group exhibited typical malignant tumor characteristics， including cellular density， large deeply stained nuclei， atypia， and reduced intercellular matrix. In tumor tissues of mice treated with ATL-Ⅱ and 5-FU， significantly reduced cell proliferation activity， loosely arranged cells， reduced mitotic activity， and markedly reduced necrotic areas were observed. In the ATL-Ⅱ medium-， high-dose groups and the 5-FU group， relatively small round or oval cells with large nuclei and deeply stained chromatin were observed. There were statistically significant differences in the percentage of positive areas for Ki-67， Caspase-3， and Bcl-2 among the five groups （F=13.86， P=0.043； F=477.63， P<0.001； F=40.48， P<0.001）. Compared with the model group， there were statistically significant differences in the ATL-Ⅱ medium-， high-dose groups and the 5-FU group （all P<0.05）. Compared with the low-dose group， there were statistically significant differences in the ATL-Ⅱ high-dose groups and the 5-FU group （both P<0.05）. Compared with the medium- and high-dose ATL-Ⅱ groups， there were statistically significant differences in the proportion of Caspase-3 positive areas in the 5-FU group （both P<0.05）. There was a statistically significant difference between the medium- and high-dose groups （P<0.05）. The positive cell rates for CD8⁺ T cells in the tumor tissues of the five groups were （10.33±3.53）%， （15.00±5.65）%， （30.33±10.51）%， （59.33±9.04）%， and （33.62±9.11）%， respectively， with a statistically significant difference （F=96.33， P<0.001）. Compared with the model group， there were statistically significant differences in the ATL-Ⅱ low-， medium-， high-dose groups and the 5-FU group （all P<0.05）. The ATL-Ⅱ medium-， high-dose groups and the 5-FU group were significantly different from the low-dose group （all P<0.05）， and a statistically significant difference was found between the medium- and high-dose groups （P<0.05）. The 5-FU group was significantly different from the ATL-Ⅱ high-dose group （P<0.05）. The positive cell rates for NK1.1 cells in the tumor tissues of the five groups were （12.33±6.52）%， （13.00±7.00）%， （35.33±9.51）%， （43.67±12.21）%， and （14.50±7.05）%， respectively， with a statistically significant difference （F=283.17， P<0.001）. The ATL-Ⅱ medium-， high-dose ATL-II groups and the 5-FU group showed statistically significant differences compared to the model group （all P<0.05）. The ATL-Ⅱ high-dose group was significantly different from the low-dose group （P<0.05）. The 5-FU group was significantly different from the ATL-Ⅱ medium- and high-dose groups （both P<0.05）. The serum GzmB levels in the five groups were （5.00±1.00）， （5.27±0.76）， （8.27±0.61）， （10.00±1.21）， （6.15±0.69） ng/L， respectively， with a statistically significant difference （F=21.45， P<0.001）. The ATL-Ⅱ medium-， high-dose groups and the 5-FU group showed statistically significant differences compared to the model group （all P<0.05）. The ATL-Ⅱ medium- and high-dose groups were significantly different from the low-dose group （both P<0.05）， and a statistically significant difference was found between the medium- and high-dose groups （P<0.05）. The 5-FU group were significantly differences from the ATL-Ⅱ medium- and high-dose groups （both P<0.05）. The serum IFN-λ levels in the five groups were （617.33±65.06）， （743.33±40.41）， （910.00±36.06）， （1 009.00±35.54）， （703.62±56.00） ng/L， respectively， with a statistically significant difference （F=43.08， P<0.001）. The ATL-Ⅱ low-， medium-， and high-dose groups showed statistically significant differences compared to the model group （all P<0.05）. The ATL-Ⅱ medium- and high-dose groups were significantly differences from the low-dose group （both P<0.05）， and a statistically significant difference was found between the medium- and high-dose groups （P<0.05）. The 5-FU group was significantly different from the ATL-Ⅱ medium- and high-dose groups （both P<0.05）. There were statistically significant differences in the expression levels of PD-L1， p-ERK/ERK， and p-MEK/MEK proteins among the five groups of tumor tissues （F=125.34， P<0.001； F=89.63， P<0.001； F=35.33， P=0.002）. Statistically significant differences in PD-L1 expression levels were found among the low-， medium-， high-dose ATL-Ⅱ groups and the 5-FU group compared to the model group （all P<0.05）. The ATL-Ⅱ high-dose group and the 5-FU group showed statistically significant differences compared to the low-dose group （both P<0.05）. A statistically significant difference was found between the ATL-Ⅱ medium- and high-dose groups （P<0.05）. The ATL-Ⅱ medium-dose group was significantly different from the 5-FU group （P<0.05）. Statistically significant differences in p-ERK/ERK expression levels were observed among the ATL-Ⅱ low-， medium-， high-dose groups and the 5-FU group compared to the model group （all P<0.05）. The ATL-Ⅱ medium-， high-dose groups and the 5-FU group showed statistically significant differences compared to the low-dose group （all P<0.05）. The 5-FU group was significantly different from the ATL-Ⅱ medium- and high-dose groups （both P<0.05）. Statistically significant differences in p-MEK/MEK expression levels were found among the ATL-Ⅱ low-， medium-， high-dose groups and the 5-FU group compared to the model group （all P<0.05）. The 5-FU group was significantly different from the low-dose group （P<0.05）. Conclusions Atractylenolide Ⅱ inhibits the activity of the ERK/MAPK signaling pathway， reduces the expression of PD-L1， enhances the infiltration of CD8+ T cells and NK cells， and promotes tumor cell apoptosis， thereby it can exert an anti-cancer effect on colon cancer. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Role and therapeutic potential of CC and CXC chemokines in the tumor microenvironment Yang Xinru, Cao Lili Journal of International Oncology    2026, 53 (4): 224-228.   DOI: 10.3760/cma.j.cn371439-20250528-00037 Abstract （191）   HTML （9）    PDF（pc） （775KB）（37）       Knowledge map    Save Chemokines are a class of cytokines with chemotactic functions that play important roles in the tumor microenvironment through receptor binding. Their functional mechanisms in tumor progression mainly include activating signaling pathways to promote tumor cell proliferation and metastasis， regulating tumor angiogenesis to alter blood supply and nutritional status， and mediating immune escape to evade host defense systems. Studies have demonstrated that targeting specific chemokine-receptor axes can effectively inhibit malignant behaviors of tumor cells and regulate immune cell infiltration， showing significant anti-tumor effects. Research on the critical roles of CC and CXC chemokines regulatory networks in the tumor microenvironment and their targeted therapeutic strategies provides an important theoretical basis and clinical application prospects for the treatment of malignant tumors. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Research progress of molecular targeted therapy of ROS1 gene mutation in non-small cell lung cancer Zhao Yue, Song Chenchen, Liang Tianci, Wang Hui, Wen Tingzhi, Rong Biaoxue Journal of International Oncology    2026, 53 (2): 105-110.   DOI: 10.3760/cma.j.cn371439-20250810-00016 Abstract （190）   HTML （4）    PDF（pc） （835KB）（16）       Knowledge map    Save The incidence of ROS1 gene rearrangement in non-small cell lung cancer （NSCLC） is 1%-2%. It is involved in the proliferation， metastasis and invasion of NSCLC cells. The advent of ROS1-tyrosine kinase inhibitors （TKIs） has significantly improved the prognosis of ROS1 gene mutant NSCLC patients. However， most patients have acquired resistance after continuous drug use， which seriously challenges the therapeutic effect of tumor targeted drugs. The molecular resistance mechanism of ROS1-TKIs is not completely understood. Further exploration of the background， mutation mode， ROS1-TKIs and resistance mechanism of ROS1 fusion gene can provide new treatment ideas for NSCLC patients resistant to ROS1-TKIs. Reference | Related Articles | Metrics | Comments（0）

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Efficacy and safety of tislelizumab combined with chemotherapy in the treatment of advanced esophageal cancer Yu Yunpeng, Dai Chunhua, Ling Rui Journal of International Oncology    2026, 53 (1): 31-37.   DOI: 10.3760/cma.j.cn371439-20250619-00004 Abstract （184）   HTML （8）    PDF（pc） （831KB）（19）       Knowledge map    Save Objective To retrospectively analyze the efficacy and safety of tislelizumab combined with chemotherapy in the treatment of advanced esophageal cancer. Methods A total of 128 patients with advanced esophageal cancer admitted to the Affiliated Hospital of Jiangsu University from March 2021 to June 2024 were selected as the study subjects. According to different treatment methods， they were divided into a conventional group （n=60， treated with paclitaxel liposome+nedaplatin） and a monoclonal antibody group （n=68， treated with paclitaxel liposome+nedaplatin+tislelizumab）. With 21 days as one cycle， a total of 4-6 cycles of chemotherapy were administered. The short-term efficacy， tumor markers and related factors， inflammatory factors， immune related indicators， quality of life-related score and safety of the two groups of patients were observed. Results After treatment， the objective response rate in the monoclonal antibody group （86.76%， 59/68） was higher than that in the conventional group （65.00%， 39/60）， with a statistically significant difference （χ2=8.42， P=0.004）. The levels of carcinoembryonic antigen （CEA）， cytokeratin 19 fragment antigen 21-1 （CYFRA21-1）， carbohydrate antigen （CA） 125， and squamous cell carcinoma antigen （SCC-Ag） in the monoclonal antibody group were （7.73±2.18） μg/L， （4.95±0.67） U/ml， （9.28±1.42） U/ml， and （0.50±0.16） μg/L， respectively， and those in the conventional group were （10.14±2.21） μg/L， （4.09±0.70） U/ml， （7.35±1.58） U/ml， and （0.68±0.22） μg/L， respectively， with statistically significant differences （t=6.20， P<0.001； t=7.10， P<0.001； t=7.28， P<0.001； t=5.34， P<0.001）. Moreover， the levels of CEA， CYFRA21-1， CA125， and SCC-Ag in both groups of patients after treatment were significantly lower than those before treatment （all P<0.05）. The levels of matrix metalloproteinase-9 （MMP-9） and vascular endothelial growth factor （VEGF） in the monoclonal antibody group were （118.28±10.47） ng/ml and （320.27±18.79） ng/L， respectively， and those in the conventional group were （126.75±14.51） ng/ml and （350.71±19.35） ng/L， respectively， with statistically significant differences （t=3.82， P<0.001； t=9.02， P<0.001）. The levels of MMP-9 and VEGF in both groups of patients after treatment were significantly lower than those before treatment （all P<0.05）. The levels of interleukin （IL）-6， C-reactive protein （CRP） and tumor necrosis factor-α （TNF-α） in the monoclonal antibody group were （5.46±1.26） ng/L， （7.89±1.45） mg/L， and （3.95±0.83） ng/L， respectively， and those in the conventional group were （8.66±2.13） ng/L， （9.51±1.64） mg/L， and （6.02±1.52） ng/L， respectively， with statistically significant differences （t=10.49， P<0.001； t=5.93， P<0.001； t=9.71， P<0.001）. The levels of IL-6， CRP， and TNF-α in both groups of patients after treatment were significantly lower than those before treatment （all P<0.05）. The T-cell subsets CD3+ and CD4+/CD8+ ratio in the monoclonal antibody group were （66.16±5.26）% and 1.52±0.25， respectively， and those in the conventional group were （58.41±5.17）% and 1.15±0.27， respectively， with statistically significant differences （t=8.39， P<0.001； t=8.05， P<0.001）. The T-cell subsets CD3+ and CD4+/CD8+ ratio in both groups of patients after treatment were significantly higher than those before treatment （all P<0.05）. Compared with before treatment， the Karnofsky performance status scores and the M. D. Anderson dysphagia inventory scores of both groups of patients were increased， and the scores in the monoclonal antibody group were significantly higher than those in the conventional group； the numerical rating scale scores of both groups were decreased， and the score in the monoclonal antibody group was significantly lower than that in the conventional group （all P<0.05）. The common adverse reactions in the two groups were leukopenia， nausea， fatigue， etc.， most of which were grade 1-2. The incidence of grade 3 adverse reactions was 10.00%（6/60） in the conventional group and 20.59%（14/68） in the monoclonal antibody group. No grade 4 adverse reactions occurred. There was no statistically significant difference in the total incidence of adverse reactions between the conventional group （78.33%， 47/60） and the monoclonal antibody group （75.00%， 51/68； χ2=0.20， P=0.657）. Conclusions Compared with chemotherapy alone， tislelizumab combined with chemotherapy in the treatment of advanced esophageal cancer can improve short-term efficacy with good safety. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Research progress on resistance mechanisms of anti-PD-1/PD-L1 therapy in advanced non-small cell lung cancer Li Ting, Zhou Qi, Zhang Qian, Chen Jie Journal of International Oncology    2026, 53 (1): 57-61.   DOI: 10.3760/cma.j.cn371439-20250319-00008 Abstract （180）   HTML （6）    PDF（pc） （831KB）（30）       Knowledge map    Save Although immune checkpoint inhibitor therapy based on anti-programmed death-1 （PD-1） and programmed death-ligand 1 （PD-L1） can significantly improve the survival prognosis of patients with advanced non-small cell lung cancer， primary and secondary drug resistance result in limited benefits for some individuals. The resistance mechanism of anti-PD-1/PD-L1 therapy is particularly complex and is influenced by multiple factors. A systematic review of the latest research results on the resistance mechanism to PD-1/PD-L1 immune checkpoint inhibitors can provide scientific basis for optimizing the treatment strategy of non-small cell lung cancer patients. Reference | Related Articles | Metrics | Comments（0）

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Evaluation of the risk of low-blood-flow BI-RADS category 4 breast lesions with an ultrasound-based XGBoost model He Yuqing, Wu Zizheng, Qi Zhengqin Journal of International Oncology    2026, 53 (3): 144-149.   DOI: 10.3760/cma.j.cn371439-20250415-00023 Abstract （180）   HTML （6）    PDF（pc） （1489KB）（14）       Knowledge map    Save Objective To develop an extreme gradient boosting （XGBoost） model based on clinical and ultrasound features，and to evaluate the model's prediction of the malignancy risk of low-blood-flow （Adler grade 0 -Ⅰ） breast imaging-reporting and data system （BI-RADS） category 4 breast lesions. Methods Clinical and ultrasound data from 317 female patients diagnosed with BI-RADS category 4 breast lesions at First Hospital of Qinhuangdao from June 2023 to December 2024 were retrospectively collected （full-sample，174 benign，143 malignant）. Patients were divided into a training set （n=222，122 benign，100 malignant） and a testing set （n=95，52 benign，43 malignant） using a 7∶3 stratified random sampling method. After excluding patients with high blood flow grades （Adler grade Ⅱ-Ⅲ），166 patients with low blood flow grades were collected and divided 7∶3 into training （n=116，71 benign，45 malignant） and testing （n=50，30 benign，20 malignant） sets. A full-sample XGBoost model for predicting the benign and malignant nature of BI-RADS category 4 breast lesions was constructed based on the well-defined epidemiological risk factors for breast cancer （age，family history of breast cancer，obesity，history of alcohol consumption，and smoking history） and the core assessment indicators for breast lesions recommended by the 2013 ACR BI-RADS classification standard （blood flow grade，maximum lesion diameter，microcalcification，shape，margin，internal echo，posterior echo，and parallel position）. After excluding the blood flow grade variable，a low-blood-flow grade XGBoost model was constructed with the remaining 12 features. The predictive efficacy was evaluated using receiver operator characteristic （ROC） curves； SHapley additive explanation （SHAP） analysis was used to quantify feature contributions； decision curve analysis （DCA） was used to assess accuracy and practicability. Results There were statistically significant differences among patients with benign and malignant breast lesions in the full sample for blood flow grade （χ²=4.99，P=0.026），maximum lesion diameter （χ²=4.47，P=0.034），microcalcifications （χ²=7.10，P=0.009），internal echo （χ²=4.24，P=0.041），and posterior echo （χ²=22.32，P<0.001）. ROC curve analysis showed that，for the full-sample training set，the area under the curve （AUC） of the XGBoost model for predicting benign and malignant BI-RADS category 4 breast lesions was 0.936 （95%CI： 0.902-0.965），with an accuracy of 86.0%，a sensitivity of 88.5%，and a specificity of 83.2%； for the testing set，the AUC was 0.852 （95%CI： 0.787-0.906），with an accuracy of 76.8%，a sensitivity of 78.6%，and a specificity of 75.0%. SHAP analysis showed that，the blood flow grade （Adler gradesⅡ-Ⅲ） had the greatest contribution to the prediction of malignancy risk by the XGBoost model for the full sample，followed by the irregularity of the margin and the absence of parallel position. For the low-blood-flow grade sample training set，the AUC of the XGBoost model for predicting benign and malignant BI-RADS category 4 breast lesions was 0.951 （95%CI： 0.917-0.975），with an accuracy of 86.5%，a sensitivity of 87.9%，and a specificity of 84.8%； for the testing set，the AUC was 0.843 （95%CI： 0.766-0.904），with an accuracy of 79.6%，a sensitivity of 81.5%，and a specificity of 77.8%. Internal validation results showed that the C-index of the XGBoost model for predicting benign and malignant breast lesions was 0.82. SHAP analysis showed that，the posterior echo attenuation had the greatest positive contribution to the prediction of malignancy risk by the XGBoost model for low-blood-flow grade samples，followed by the presence of microcalcification，maximum lesion diameter >2 cm，and inhomogeneous internal echo. DCA showed that this prediction model could provide high clinical net benefit and had certain clinical practicability. Conclusions The XGBoost model based on clinical and ultrasound features effectively evaluates benign and malignant nature of low-blood-flow BI-RADS category 4 breast lesions. Posterior echo attenuation，microcalcification，maximum lesion diameter >2 cm，and inhomogeneous internal echo are key features for predicting malignancy risk in low-blood-flow BI-RADS category 4 breast lesions. Table and Figures | Reference | Related Articles | Metrics | Comments（0）