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08 May 2024, Volume 51 Issue 5 Previous Issue    Next Issue

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Predictive value of changes in inflammatory markers for prognosis in patients with advanced non-small cell lung cancer treated with the first-line immunotherapy plus chemotherapy Fan Zhipeng, Yu Jing, Hu Jing, Liao Zhengkai, Xu Yu, Ouyang Wen, Xie Conghua 2024, 51 (5):  257-266.  doi: 10.3760/cma.j.cn371439-20240215-00044 Abstract ( 85 )   HTML ( 16 )   PDF (1792KB) ( 70 )   Save Objective To investigate the correlation between pre- and post-treatment changing trends in peripheral blood inflammatory markers and efficacy and their predictive value for prognosis in non-small cell lung cancer （NSCLC） patients treated with the first-line immunotherapy plus chemotherapy. Methods The clinical data of NSCLC patients admitted to the Department of Radiation and Chemotherapy for Lung Oncology， Zhongnan Hospital of Wuhan University from October 2018 to May 2023 were retrospectively analyzed. The χ2 test was used to analyze the correlation between the changing trend of peripheral blood inflammatory markers and the efficacy of immunotherapy plus chemotherapy. The influencing factors of objective response rate （ORR） were assessed using binary logistic regression analysis. Kaplan-Meier survival curve and Cox proportional hazards model were used to analyze the prognostic value of the changing trend of peripheral blood inflammation markers on patients' prognosis. Results A total of 102 NSCLC patients treated with first-line immunotherapy plus chemotherapy were included. The proportion of patients with bone metastases was higher in the lymphocyte to monocyte ratio （LMR） decreased group （n=50） than that in the increased group （n=52） （χ2=4.28， P=0.039）， whereas the pathological type of patients in the platelet to lymphocyte ratio （PLR） decreased group （n=51） was more common in squamous carcinoma compared to patients in the increased group （n=51） （χ2=18.99， P<0.001）， and a higher proportion of patients in the prognostic nutritional index （PNI） decreased group （n=46） was female than that in the increased group （n=56） （χ2=4.29， P=0.038）， with statistically significant differences. The 2-cycle objective response rate （ORR） of patients in the LMR increased and decreased groups was 63.5% （33/52） and 44.0% （22/50） （χ2=3.89， P=0.049）， the 2-cycle ORR of patients in the neutrophil to lymphocyte ratio （NLR） increased （n=24） and decreased （n=78） groups was 29.2% （7/24） and 61.5% （48/78） （χ2=7.74， P=0.005）， and the 2-cycle ORR for patients in the systemic immune inflammatory index （SII） increased group （n=27） and decreased group （n=75） was 33.3% （9/27） and 61.3% （46/75） （χ2=6.26， P=0.012）， with statistically significant differences. Multivariate analysis showed that the changing trend of inflammatory markers in peripheral blood were not related to ORR. The Kaplan-Meier survival curve indicated that patients in the group with SII decreased had longer median progression-free survival （PFS） （not reached vs. 7.1 months， χ2=9.35， P=0.002） and median overall survival （OS） （not reached vs. 16.6 months， χ2=11.08， P<0.001） than those in the SII increased group， and patients in the NLR decreased group had longer median OS （not reached vs. 22.2 months， χ2=4.56， P=0.033） than that in the NLR increased group. Univariate analysis suggested that both brain and bone metastasis （HR=4.04， 95%CI： 1.23-13.35， P=0.022）， increased SII （HR=2.83， 95%CI： 1.41-5.66， P=0.003） were found to be significant factors affecting the PFS of NSCLC patients， both brain and bone metastasis （HR=3.47， 95%CI： 1.05-11.45， P=0.041）， increased NLR （HR=2.17， 95%CI： 1.05-4.51， P=0.037） and increased SII （HR=3.12， 95% CI： 1.54-6.30， P=0.002） were found to be significant factors affecting the OS of NSCLC patients. Multivariate analysis demonstrated that both brain and bone metastasis （HR=4.32， 95%CI： 1.30-14.40， P=0.017） and increased SII （HR=2.89， 95%CI： 1.44-5.81， P=0.003） were independent risk factors for PFS in NSCLC patients， both brain and bone metastasis （HR=3.76， 95%CI： 1.13-12.50， P=0.031） and increased SII （HR=3.47， 95% CI： 1.28-9.41， P=0.014） remained independent risk factors for OS in patients with NSCLC. Conclusion The changing trend of peripheral blood inflammatory markers of NSCLC patients cannot independently predict the efficacy of 2-cycle immunotherapy plus chemotherapy. Both brain and bone metastasis， as well as the changing trend of SII can be used as important indicators to predict PFS and OS in advanced NSCLC patients treated with first-line immunotherapy plus chemotherapy. The simultaneous occurrence of brain and bone metastasis and SII increased suggest poor prognosis of NSCLC patients. Figures and Tables | References | Related Articles | Metrics

Prognostic model construction of lung infection in patients with chemoradiotherapy for esophageal cancer based on SMOTE algorithm Liu Jing, Liu Qin, Huang Mei 2024, 51 (5):  267-273.  doi: 10.3760/cma.j.cn371439-20230621-00045 Abstract ( 49 )   HTML ( 9 )   PDF (1108KB) ( 36 )   Save Objective To explore the independent risk factors of lung infection in patients with esophageal cancer treated with chemoradiotherapy and to establish an individualized early warning model based on synthetic minority oversampling technique （SMOTE） algorithm. Methods A total of 197 patients with esophageal cancer who received concurrent chemoradiotherapy in Nanchong Central Hospital of Sichuan Province from January 2016 to March 2022 were selected as the study objects. Patients were categorized into the infected group （n=23） and the uninfected group （n=174） according to whether they developed lung infection during treatment. The clinical data of patients in both groups were collected， and independent risk factors for lung infection were screened using univariate and binary logistic regression analysis， and a logistic regression model （P1） was established， while an early warning model （P2） was constructed based on the improved dataset with the SMOTE algorithm， and the predictive efficiency of the model was compared by receiver operator characteristic （ROC） curve. Results The incidence of lung infection in 197 patients was 11.7% （23/197）， Univariate analysis showed that there were statistically significant differences in the age （t=3.53， P=0.001）， the proportion of patients with a smoking index of ≥200 cigarette-years （χ2=7.64， P=0.006）， the proportion of patients with concomitant radiological lung injury （χ2=5.41， P=0.020）， the proportion of patients with comorbid diabetes mellitus （χ2=6.71， P=0.010）， the proportion of patients with chronic obstructive lung disease （χ2=3.92， P=0.048） and forced expiratory volume in one second/forced vital capacity （FEV1/FVC） （t=3.93， P<0.001） of patients between the infected group and the uninfected group. Logistic regression multivariate analysis found that increasing patient age （OR=1.09， 95%CI： 1.02-1.16， P=0.008）， decreased FEV1/FVC （OR=0.92， 95%CI： 0.87-0.98， P=0.005）， combined diabetes mellitus （OR=3.29， 95%CI： 1.22-8.91， P=0.019）， smoking index ≥200 cigarette-years （OR=4.02， 95%CI： 1.42-11.41， P=0.009） and combined radiation lung injury （OR=4.75， 95%CI： 1.26-17.85， P=0.021） were independent risk factors for the occurrence of lung infection during simultaneous chemoradiotherapy in patients with esophageal cancer. Probabilistic prediction model logit（P1）=-2.760+0.084×age-0.081×FEV1/FVC+1.191×diabetes+1.392×smoking index+1.558×radiation lung injury. The early warning model logit（P2）=-1.544-0.127×age-0.115×FEV1/FVC+1.599×diabetes+1.434×smoking index+1.748×radiation lung injury. ROC curve analysis showed that the sensitivity of P1 and P2 models were 0.826 and 0.897， the specificity were 0.747 and 0.793， and the Youden index were 0.573 and 0.690， respectively. The area under curve of P2 model was 0.903 （95%CI： 0.872-0.934）， which was significantly higher than 0.843 （95%CI： 0.763-0.923） of P1 model， with a statistically significant difference （Z=13.23， P=0.002）. Conclusion Increasing patient age， decreased FEV1/FVC， smoking index ≥200 cigarette-years， combined diabetes mellitus and radiation lung injury are strongly associated with the occurrence of lung infection during simultaneous chemoradiotherapy in patients with esophageal cancer. The individualized early warning model established by SMOTE algorithm can significantly improve the predictive efficacy of patients' occurrence of lung infection. Figures and Tables | References | Related Articles | Metrics

Study on the clinical relationship between inflammatory burden index and gastric cancer Yang Lin, Lu Ning, Wen Hua, Zhang Mingxin, Zhu Lin 2024, 51 (5):  274-279.  doi: 10.3760/cma.j.cn371439-20231017-00046 Abstract ( 57 )   HTML ( 15 )   PDF (1282KB) ( 73 )   Save Objective To analyze the relationship between inflammatory burden index （IBI） and the diagnosis and prognosis of gastric cancer. Methods A total of 180 patients with gastric cancer admitted to the First Affiliated Hospital of Xi'an Medical University from January 1， 2017 to December 31， 2021 were selected as the gastric cancer group， 180 cases of gastric precancerous diseases treated in this hospital during the same period were selected as the precancerous disease group， 180 healthy individuals who underwent physical examinations in this hospital during the same period were selected as the control group. The value of IBI in the diagnosis of gastric cancer was analyzed. The IBI values of the three groups were compared by one-way analysis of variance， and the optimal cut-off values of different indicators were determined by receiver operator characteristic （ROC） curve to further evaluate the diagnostic value of IBI for gastric cancer. LASSO regression analysis was performed using the R software package glmnet to screen variables. Univariate and multivariate Cox regression analysis were performed on the screened variables to further determine the independent risk factors affecting the prognosis of patients with gastric cancer. Results The levels of IBI in gastric cancer， precancerous disease， and control group were 46.69±8.38， 35.53±6.11， and 21.47±4.36， respectively， with a statistically significant difference （F=681.45， P<0.001）. Further pairwise comparisons showed that the gastric cancer group was higher than the precancerous disease group and the control group, and the precancerous disease group was higher than the control group， with statistically significant differences（t=14.43， P<0.001; t=34.15， P<0.001; t=25.13， P<0.001）. ROC curve analysis showed that the optimal cut-off value for the neutrophil to lymphocyte ratio （NLR） was 3.15 （AUC=0.65， 95%CI： 0.54-0.73）， with a specificity of 92.31% and a sensitivity of 43.97%. The optimal cut-off value for the platelet to lymphocyte ratio （PLR） was 137.36 （AUC=0.59， 95%CI： 0.51-0.68）， with a specificity of 93.66% and a sensitivity of 34.98%. The optimal cut-off value for lymphocyte to monocyte ratio （LMR） was 5.18 （AUC=0.69， 95%CI： 0.58-0.76）， with a specificity of 61.29% and a sensitivity of 73.33%. The optimal cut-off value for panimmune inflammation value （PIV） was 276.57 （AUC=0.73， 95%CI： 0.65-0.78）， with a specificity of 78.41% and a sensitivity of 59.77%. The optimal cut-off value for the systemic immune inflammatory index （SII） was 654.37 （AUC=0.73， 95%CI： 0.66-0.78）， with a specificity of 86.32% and a sensitivity of 62.11%. The optimal cut-off value for the IBI was 49.12 （AUC=0.82， 95%CI： 0.79-0.92）， with a specificity of 85.36% and a sensitivity of 65.82%. LASSO regression analysis showed that there were 8 prognostic variables related to survival， including IBI， T stage， N stage， age， carcinoembryonic antigen（CEA）， SII， PIV， and tumor grade. The results of univariate analysis showed that IBI （HR=4.57， 95%CI： 3.82-5.32， P<0.001）， T stage （HR=2.54， 95%CI： 1.75-3.31， P<0.001）， N stage （HR=1.69， 95%CI： 1.15-2.21， P=0.032）， CEA （HR=1.38， 95%CI： 1.06-1.75， P=0.032）， and tumor grade （HR=1.87， 95%CI： 1.34-2.59， P=0.026） were prognostic factors for gastric cancer patients. The results of multivariate analysis showed that IBI （HR=3.96， 95%CI： 3.51-4.48， P<0.001）， T stage （HR=2.31， 95%CI： 1.63-3.02， P=0.023）， tumor grade （HR=1.49， 95%CI： 1.12-1.83， P=0.042） were independent risk factors affecting the prognosis of gastric cancer patients. Compared with low-level IBI gastric cancer patients， the risk of death in high-level IBI patients was up to 3.96 times. Conclusion IBI may be an important marker for diagnosis and prognosis prediction of gastric cancer， which has certain scientific and clinical value in the diagnosis and treatment of gastric cancer. Figures and Tables | References | Related Articles | Metrics

Effect of cancer nodules on liver metastases after radical resection of colorectal cancer Wang Junyi, Hong Kaibin, Ji Rongjia, Chen Dachao 2024, 51 (5):  280-285.  doi: 10.3760/cma.j.cn371439-20231017-00047 Abstract ( 50 )   HTML ( 13 )   PDF (851KB) ( 40 )   Save Objective To investigate the effect of cancer nodules on postoperative liver metastasis in patients undergoing radical resection of colorectal cancer. Methods The clinicopathological data of 196 patients undergoing radical operation for colorectal cancer admitted to the Dongnan Hospital of Xiamen University from January 2019 to June 2020 were retrospectively analyzed. According to the pathological results， they were divided into cancer nodule group and non-cancer nodule group. Time and the number of liver metastasis during the follow-up period were analyzed. The relationship between cancer nodules and clinicopathological features was analyzed， and the influencing factors of postoperative liver metastasis in patients with colorectal cancer were analyzed by univariate and logistic multivaiate analysis. The receiver operator characteristic （ROC） curve was drawn to analyze the predictive effect of cancer nodule diameter on postoperative liver metastasis of colorectal cancer. Results There were 50 patients accompanied by cancer nodules in 196 patients with colorectal cancer， the incidence rate was 25.5%， the diameter of cancer nodules was 0.4-1.8 cm， the median diameter was 1.0 cm， and there were 46 patients with liver metastasis， the incidence rate was 23.5%. There were statistically significant differences in carbohydrate antigen CA19-9 （χ2=7.55， P=0.006）， maximum tumor diameter （χ2=12.23， P<0.001）， T stage （χ2=15.79， P<0.001）， vascular thrombus （χ2=12.79， P<0.001）， lymph node metastasis （χ2=16.18， P<0.001） between the cancer nodule group and the non-cancer nodule group. Univariate analysis showed that CA19-9 （χ2=7.40， P=0.007）， maximum tumor diameter （χ2=8.23， P=0.004）， T stage （χ2=4.58， P=0.032）， vascular cancer thrombus （χ2=12.97， P<0.001）， lymph node metastasis （χ2=3.96， P=0.047）， cancer nodules （χ2=67.60， P<0.001）， cancer nodule diameter （t=4.28， P<0.001）， and the number of cancer nodules （χ2=68.77， P<0.001） were all influential factors for postoperative liver metastasis in colorectal cancer patients. Multivariate analysis showed that stage T3-4 （OR=4.62， 95%CI： 1.51-7.35， P=0.003）， vascular cancer thrombus （OR=5.42， 95%CI：1.75-12.85， P<0.001）， accompanied by cancer nodules （OR=18.54， 95%CI： 7.45-39.73， P<0.001）， the diameter of cancer nodules （OR=13.20， 95%CI： 4.74-29.64， P<0.001）， number of nodules [one cancer nodule （OR=9.11， 95%CI： 2.24-27.34， P<0.001）， two cancer nodules （OR=6.36， 95%CI： 1.38-9.08， P<0.001） and three cancer nodules （OR=5.00， 95%CI： 1.98-8.84， P<0.001）] were independent influencing factors for postoperative liver metastasis in patients with colorectal cancer. ROC curve analysis showed that the best threshold of the diameter of cancer nodules for predicting liver metastasis was 1.1 cm [area under the curve （AUC）=0.764， 95%CI： 0.632-0.896， P=0.002）. The incidence of liver metastasis in patients with cancer nodules diameter≥1.1 cm was 95.65%（22/23）， higher than that in patients with cancer nodules diameter<1.1 cm （40.74%，11/27）， with a statistically significant difference （χ2=16.69， P<0.001）. Conclusion Patients with colorectal cancer with cancer nodules≥1.1 cm in diameter should be vigilant against postoperative liver metastasis. Figures and Tables | References | Related Articles | Metrics

Diagnostic value of cervical cell DNA ploidy analysis combined with B7-H4 and PKCδ for cervical cancer Zhang Ningning, Yang Zhe, Tan Limei, Li Zhenning, Wang Di, Wei Yongzhi 2024, 51 (5):  286-291.  doi: 10.3760/cma.j.cn371439-20230722-00048 Abstract ( 51 )   HTML ( 10 )   PDF (1183KB) ( 27 )   Save Objective To investigate the diagnostic value of cervical cell DNA ploidy analysis combined with negative costimulatory molecule B7 homolog 4 （B7-H4） and protein kinase Cδ （PKCδ） for cervical cancer. Methods A total of 160 cervical cancer patients diagnosed and treated at Shijiazhuang People's Hospital from January 2018 to January 2022 were selected as the cervical cancer group. Meantime， 160 women who were screened for cervical cancer in our hospital during this period were selected as the control group. According to the examination results， they were divided into normal or inflammatory group （n=52）， low-grade cervical intraepithelial neoplasia （CIN） group （n=68） and high-grade CIN group （n=40）. The automatic cell image analysis system was used to analyze the DNA ploidy of cervical cells. The levels of B7-H4 and PKCδ in serum were determined by enzyme-linked immunosorbent assay. Pearson method was used to analyze the correlation between serum B7-H4 and PKCδ; the diagnostic value of cervical cell DNA ploidy analysis combined with serum B7-H4 and PKCδ in cervical cancer was evaluated by the receiver operator characteristic （ROC） curve; multivariate logistic regression was used to analyze the risk factors of cervical cancer. Results The numbers of DNA ploidy positive cases of cervical cells in normal or inflammatory group， low-grade CIN group， high-grade CIN group and cervical cancer group were 16 （30.8%）， 27 （39.7%）， 26 （65.0%） and 127 （79.4%）， respectively， with a statistically significant difference （H=55.86， P<0.001）. Further pin-by-pair comparison showed that compared with normal or inflammatory groups， the proportion of DNA ploidy positive in high-grade CIN group and cervical cancer group were higher （both P<0.05）. The proportion of DNA ploidy positive in cervical cancer group was higher than that in low-grade CIN group （P<0.05）. Serum B7-H4 levels in normal or inflammatory group， low-grade CIN group， high-grade CIN group and cervical cancer group were （57.21±10.21）， （79.17±11.34）， （92.73±15.36）， （126.56±20.25） ng/ml， respectively， with a statistically significant difference （F=285.45， P<0.001）. Serum PKCδ levels were （89.34±18.29）， （71.79±15.82）， （53.39±11.84）， （40.23±10.21） ng/ml， respectively， with a statistically significant difference （F=216.28， P<0.001）. Further pin-by-pair comparison showed that serum B7-H4 levels in normal or inflammatory groups， low-grade CIN group， high-grade CIN group and cervical cancer group increased in turn （all P<0.05）. Serum PKCδ levels in normal or inflammatory groups， high-grade CIN group and cervical cancer group were decreased in turn （all P<0.05）. Pearson correlation analysis showed that the serum B7-H4 and PKCδ levels in patients with cervical cancer were negatively correlated （r=-0.47， P<0.001）. ROC curve analysis showed that the area under the curve （AUC） of cervical cell DNA ploidy for cervical cancer diagnosis was 0.82 （95%CI： 0.78-0.86）， and the sensitivity and specificity were 83.9% and 79.9%， respectively. The AUC of serum B7-H4 in the diagnosis of cervical cancer was 0.92 （95%CI： 0.89-0.95）， the sensitivity and specificity were 95.7% and 76.1%， respectively， and the cutoff value was 111.12 ng/ml. The AUC of serum PKCδ for diagnosis of cervical cancer was 0.92 （95%CI： 0.89-0.95）， the sensitivity and specificity were 85.6% and 88.9%， respectively， and the cut-off value was 54.83 ng/ml. The AUC of the combined diagnosis of cervical cancer was 0.99 （95%CI： 0.97-0.99）， and the sensitivity and specificity were 98.3% and 75.9%， respectively. The AUC of the combined diagnosis of cervical cancer was higher than that of DNA ploidy （Z=8.00， P<0.001）， serum B7-H4 （Z=4.34， P<0.001）， and serum PKCδ （Z=4.61， P<0.001） alone. Multivariate logistic regression analysis showed that high level of B7-H4 in serum （OR=2.94，95%CI： 1.78-4.84， P<0.001）， low level of PKCδ （OR=4.33，95%CI： 1.88-10.00， P=0.001） and positive DNA ploidy in cervical cells （OR=5.77，95%CI： 2.38-13.99， P<0.001） were independent risk factors for cervical cancer. Conclusion The positive proportion of DNA ploidy in cervical cells of patients with cervical cancer is increased， the serum B7-H4 level is increased， the PKCδ level is decreased， and cervical cell DNA ploidy analysis combined with serum B7-H4 and PKCδ has a high diagnostic value for cervical cancer. Figures and Tables | References | Related Articles | Metrics

Reviews

Research progress of habitat analysis in radiomics of malignant tumors Fu Yi, Ma Chenying, Zhang Lu, Zhou Juying 2024, 51 (5):  292-297.  doi: 10.3760/cma.j.cn371439-20240108-00049 Abstract ( 249 )   HTML ( 24 )   PDF (722KB) ( 162 )   Save Nowadays， the research on traditional radiomics has gradually matured. However， it usually regards the tumor as a whole， and high-throughput data are often generated in the entire tumor region， which cannot express clear spatial heterogeneity. In order to explore the potential biological information within tumors and realize individualized precise diagnosis and treatment， habitat analysis technology emerges at the historic moment， which provides a new way of thinking to identify tumor microenvironment. On the basis of traditional radiomics， the tumor cell population with similar characteristics is clustered， and the tumor is segmented into multiple sub-regions. Therefore， the study of tumor is no longer limited by the subjective differences of observers in the description of imaging features， and the information of tumor spatial heterogeneity is ideally obtained. References | Related Articles | Metrics

Current application status of hyperspectral imaging in the diagnosis and treatment of head and neck tumor Chen Qi, Xu Chenyang, Wang Yin, Lei Dapeng 2024, 51 (5):  298-302.  doi: 10.3760/cma.j.cn371439-20231026-00050 Abstract ( 34 )   HTML ( 4 )   PDF (710KB) ( 23 )   Save Head and neck tumor is a common malignant tumor with increasing incidence and mortality worldwide. Traditional diagnostic methods for head and neck tumor are limited by the lack of specific biomarkers and the limitation of invasive detection methods， as well as high time cost and a high rate of misdiagnosis. Therefore， research on head and neck tumor diagnosis based on new technologies is needed. Hyperspectral imaging （HSI） is a non-contact optical imaging technique that captures a series of images in multiple spectral bands to generate a hyperspectral image cube. HSI has shown its corresponding potential in the early diagnosis， tumor margin identification and clinical research of head and neck cancer. References | Related Articles | Metrics

Research progress on artificial intelligence-assisted electronic laryngoscopy in the diagnosis and treatment of laryngeal cancer and laryngeal precancerous lesions Gu Fangmeng, Xu Chenyang, Lei Dapeng 2024, 51 (5):  303-307.  doi: 10.3760/cma.j.cn371439-20240318-00051 Abstract ( 57 )   HTML ( 5 )   PDF (739KB) ( 29 )   Save Due to the significant anatomical location and physiological functions of the larynx， laryngeal lesions can severely impact patients' voice， quality of life， and even survival prognosis， making early diagnosis and treatment crucial. The electronic laryngoscope is the most important auxiliary tool for the early diagnosis and treatment of laryngeal cancer and precancerous lesions. In recent years， the rapid development of artificial intelligence technology has led to increasing applications and research in the field of laryngoscopy， demonstrating enormous potential and value in assisting diagnosis， quality control， and post-treatment evaluation of diseases. It is expected to become a powerful assistant for endoscopists in clinical decision-making and early diagnosis and treatment of laryngeal cancer in the future. References | Related Articles | Metrics

Progress of ferroptosis-related mechanisms in osteosarcoma Wang Peixin, Zhao Jun, Xu Shihong, Jiang Zhaoyang, Wang Xiaoqiang, Yang Hongjuan 2024, 51 (5):  308-311.  doi: 10.3760/cma.j.cn371439-20240304-00052 Abstract ( 74 )   HTML ( 3 )   PDF (725KB) ( 35 )   Save Osteosarcoma is a common primary malignant bone tumor with highly aggressive and distal metastasis and poor prognosis. Abnormal metabolism of iron， an essential nutrient with electron-exchange capacity and an important participant in cellular activities， is closely associated with the progression of osteosarcoma. Ferroptosis has been shown to regulate osteosarcoma progression and play an important role in the treatment of osteosarcoma. Exploring the application of relevant molecular mechanisms of ferroptosis in osteosarcoma and the current status of pharmacological intervention may provide new strategies for the treatment of osteosarcoma. References | Related Articles | Metrics