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Journal of International Oncology    2025, 52 (8): 470-483.   DOI: 10.3760/cma.j.cn371439-20250312-00082 Abstract （1120）   HTML （55）    PDF（pc） （1051KB）（974）       Knowledge map    Save Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Journal of International Oncology    2026, 53 (1): 1-15.   DOI: 10.3760/cma.j.cn371439-20251228-00001 Abstract （338）   HTML （23）    PDF（pc） （3271KB）（176）       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 （333）   HTML （6）    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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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 Journal of International Oncology    2025, 52 (8): 484-494.   DOI: 10.3760/cma.j.cn371439-20250606-00083 Abstract （278）   HTML （13）    PDF（pc） （1029KB）（362）       Knowledge map    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. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Journal of International Oncology    2025, 52 (8): 465-469.   DOI: 10.3760/cma.j.cn371439-20250722-00081 Abstract （247）   HTML （10）    PDF（pc） （12178KB）（117）       Knowledge map    Save 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 （235）   HTML （11）    PDF（pc） （1335KB）（37）       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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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 （228）   HTML （16）    PDF（pc） （2163KB）（49）       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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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 Journal of International Oncology    2025, 52 (8): 508-516.   DOI: 10.3760/cma.j.cn371439-20250328-00086 Abstract （220）   HTML （3）    PDF（pc） （1554KB）（16）       Knowledge map    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. 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 （218）   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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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 （217）   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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Clinical applications of TCR sequencing in cancer immunotherapy Wu Xuehui, Li Song, Liu Lian Journal of International Oncology    2025, 52 (8): 523-527.   DOI: 10.3760/cma.j.cn371439-20250312-00088 Abstract （215）   HTML （7）    PDF（pc） （912KB）（39）       Knowledge map    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. 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 （207）   HTML （10）    PDF（pc） （763KB）（36）       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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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 （201）   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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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 Journal of International Oncology    2025, 52 (8): 495-501.   DOI: 10.3760/cma.j.cn371439-20241108-00084 Abstract （200）   HTML （7）    PDF（pc） （1101KB）（50）       Knowledge map    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. Table and Figures | 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 （199）   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 （197）   HTML （8）    PDF（pc） （1235KB）（181）       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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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 Journal of International Oncology    2025, 52 (8): 532-537.   DOI: 10.3760/cma.j.cn371439-20241203-00090 Abstract （192）   HTML （6）    PDF（pc） （933KB）（20）       Knowledge map    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. 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 （192）   HTML （2）    PDF（pc） （1048KB）（13）       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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Prediction model for post-TACE infection risk in elderly patients with liver cancer Huang Jinfa, Zheng Lianqiu, Wu Jinpiao, Liu Deting, Chen Huiling Journal of International Oncology    2025, 52 (8): 517-522.   DOI: 10.3760/cma.j.cn371439-20240528-00087 Abstract （188）   HTML （8）    PDF（pc） （1582KB）（17）       Knowledge map    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. 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 （186）   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）