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Laryngeal cancer burden, risk attribution, and forecasts in mainland China and Taiwan: a Global Burden of Disease 2023 analysis.
IF 3.5 Q3 Medicine Pub Date : 2026-10-24 DOI: 10.1016/j.ctarc.2026.101502
Li-Juan Zhou, Ying Huang, Lei Wang

Background: Comparative evidence on laryngeal cancer burden in mainland China and Taiwan remains limited.

Methods: We analysed Global Burden of Disease (GBD) 2023 estimates for 1990-2023 and conditional projections to 2040. Outcomes included incident cases, deaths, disability-adjusted life-years (DALYs), and age-standardised incidence (ASIR), death (ASDR) and DALY (ASDALY) rates. Analyses covered Joinpoint trends, Socio-demographic Index (SDI) associations, population-attributable fractions (PAFs), Bayesian age-period-cohort (BAPC) projections and fixed-rate demographic scenarios. Between-location rate ratios used approximate 95% uncertainty intervals (UIs) with correlation sensitivity analyses.

Results: Mainland China had 43.05 thousand incident cases, 20.41 thousand deaths and 509.19 thousand DALYs in 2023; Taiwan had 0.83 thousand, 0.29 thousand and 7.20 thousand, respectively. Burden was concentrated among older men. Both-sex mainland China-to-Taiwan rate ratios were 0.959 (approximate 95% UI 0.681-1.350) for ASIR, 1.351 (1.029-1.772) for ASDR and 1.285 (0.974-1.694) for ASDALY, assuming zero cross-location covariance. ASDR declined overall by 1.74% annually in mainland China and 2.38% in Taiwan; corresponding ASDALY declines were 1.81% and 2.10%. Mainland China's male ASIR increased during 2014-2023. SDI associations weakened in sensitivity analyses. Tobacco and high alcohol use contributed substantially to attributable burden. Forecasts were uncertain; demographic scenarios suggested increasing case numbers despite population decline.

Conclusions: Priorities include tobacco and alcohol control, occupational-risk reduction, timely diagnosis, and equitable treatment and rehabilitation. Ecological associations and conditional projections do not establish causality or deterministic future outcomes.

方法:我们分析了全球疾病负担(GBD) 2023年对1990-2023年的估计和2040年的条件预测。结果包括事件病例、死亡、残疾调整生命年(DALYs)、年龄标准化发病率(ASIR)、死亡(ASDR)和DALY (ASDALY)率。分析包括结合点趋势、社会人口指数(SDI)关联、人口归因分数(paf)、贝叶斯年龄-时期-队列(BAPC)预测和固定比率人口情景。位置间比率使用了接近95%的不确定区间(ui)和相关敏感性分析。2023年,发病0.5万例,死亡20.41万例,残疾调整生活年数509.19万例;台湾分别为0.83万人、0.29万人和720万人。负担集中在老年人身上。假设交叉位置协方差为零,大陆与台湾的性别比率ASIR为0.959(约95% UI 0.881 -1.350), ASDR为1.351 (1.029-1.772),ASDALY为1.285(0.974-1.694)。台湾地区的ASDR整体下降1.38%;相应的ASDALY下降1.81%和2.10%。2014-2023年中国大陆男性ASIR增加。在敏感性分析中,SDI关联减弱。烟草和大量饮酒是造成可归责负担的主要原因。预测不确定;人口统计情景表明,尽管人口减少,但病例数仍在增加。结论:重点是控制烟酒、降低职业风险、及时诊断、公平治疗和康复。生态关联和条件预测不能建立因果关系或确定的未来结果。
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引用次数: 0
CT-guided iodine-125 brachytherapy for advanced thymic epithelial tumors: a preliminary observational study. ct引导下碘-125近距离治疗晚期胸腺上皮肿瘤:初步观察研究。
IF 3.5 Q3 Medicine Pub Date : 2026-10-23 DOI: 10.1016/j.ctarc.2026.101500
Ziyu Tang, Shixiang Qiu, Yunguo Liao, Xin Wen, Guojun Zhang, Jiaqi Pu, Xin Wei, Chao Li

Objective: This study aimed to provide a preliminary description of the application of CT-guided iodine-125 (125I) seed implantation, a form of brachytherapy, in patients with advanced or recurrent thymic epithelial tumors (TETs).

Methods: We retrospectively reviewed seven patients with advanced or recurrent TETs who underwent CT-guided 125I seed implantation. Based on the extent of disease at presentation, one patient had widespread distant metastases, while the remaining six had localized lesions. Treatment planning was performed using a treatment planning system(TPS, Beijing Astro Technology Co., Ltd.) with a prescribed dose of 60-70 Gy. Follow-up evaluations included regular contrast-enhanced CT scans. Tumor response was assessed according to RECIST 1.1 criteria, and safety was evaluated using CTCAE v5.0.

Results: A total of 12 lesions were treated across seven patients. All procedures were technically successful. Over a median follow-up of 46 months (range: 9-69 months),four patients (57.1%) attained a complete response (CR) and three patients (42.9%) attained a partial response (PR) at the patient level. Patient-level response was defined by composite assessment of all target lesions. At the lesion level, six lesions (50%) demonstrated a CR and six lesions (50%) demonstrated a partial response PR. Notably, lesion-level observations are statistically non-independent given that half of treated lesions derived from a single patient. Complications included pneumothorax in three patients (one of whom required drainage) and grade 1 radiation pneumonitis in one patient; all adverse events resolved without long-term sequelae. No severe radiation-related toxicities (e.g., pericarditis) were observed. In a descriptive subgroup excluding the patient with widespread metastases, four of six patients achieved CR and two achieved PR; no local progression was documented during available follow-up, but this finding remains descriptive and non-comparative.

Conclusion: CT-guided ¹²⁵I radioactive seed implantation appears feasible and well-tolerated in patients with advanced or recurrent TETs. The observed objective tumour responses and toxicity profile are hypothesis-generating but must be interpreted with caution given the very small sample size, heterogeneous cohort, non-independent lesion-level data, and lack of a control group. This preliminary study cannot establish durable local control or superiority over external beam radiotherapy. Further larger, prospective studies with standardized dosimetry and time-to-event endpoints are warranted.

目的:本研究旨在初步描述ct引导下碘125 (125I)粒子植入术(一种近距离治疗方法)在晚期或复发性胸腺上皮肿瘤(tet)患者中的应用。方法:我们回顾性分析了7例晚期或复发性tet患者行ct引导下的125I粒子植入。根据疾病的程度,1例患者有广泛的远处转移,而其余6例患者有局限性病变。使用治疗计划系统(TPS, Beijing Astro Technology Co., Ltd)进行治疗计划,处方剂量为60-70 Gy。随访评估包括定期CT增强扫描。根据RECIST 1.1标准评估肿瘤反应,使用CTCAE v5.0评估安全性。结果:7例患者共治疗12个病灶。所有手术在技术上都是成功的。在中位随访46个月(范围:9-69个月)期间,4例患者(57.1%)达到完全缓解(CR), 3例患者(42.9%)达到部分缓解(PR)。通过对所有目标病变的综合评估来确定患者水平的反应。在病变水平,6个病变(50%)表现为CR, 6个病变(50%)表现为部分缓解PR。值得注意的是,病变水平的观察结果在统计上是非独立的,因为治疗的病变中有一半来自单个患者。并发症包括3例患者气胸(其中1例需要引流)和1例患者1级放射性肺炎;所有不良事件均得到解决,无长期后遗症。未观察到严重的辐射相关毒性(如心包炎)。在排除广泛转移患者的描述性亚组中,6例患者中有4例达到CR, 2例达到PR;在可用的随访中没有记录局部进展,但这一发现仍然是描述性的,非可比性的。结论:ct引导的¹²5 - 1放射性粒子植入术对于晚期或复发性tet患者是可行且耐受性良好的。观察到的客观肿瘤反应和毒性概况是假设产生的,但必须谨慎解释,因为样本量很小,异质性队列,非独立的病变水平数据,缺乏对照组。这项初步研究不能确定持久的局部控制或优于外部放射治疗。采用标准化剂量学和事件时间终点的更大规模的前瞻性研究是有必要的。
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引用次数: 0
Comparative assessment of skin toxicity in prone vs supine positions during postoperative breast radiotherapy: A systematic review and meta-analysis. 术后乳房放疗中俯卧位与仰卧位皮肤毒性的比较评价:系统回顾和荟萃分析。
IF 3.5 Q3 Medicine Pub Date : 2026-10-22 DOI: 10.1016/j.ctarc.2026.101501
Fnu Sawaira, Aizaz Anwar Khalid, Hassaan Qazi, Sooraj Kukreja, Muhammad Yasir, Shariq Hayat, Muhammad Waqas, Muhammad Junaid, Sarim Hassan Shahab, Owais Gul, Muhammad Mughees, Muhammad Suliman Sajid, Umar Farooq, Mujeeb Ur Rehman, Muhammad Arsalan
<p><strong>Background: </strong>Breast-conserving surgery followed by adjuvant whole-breast irradiation (WBI) is the standard of care for early-stage breast cancer. Patient positioning during WBI, prone versus supine, may influence the incidence and severity of radiation-induced skin toxicity. However, existing studies have reported inconsistent findings, and no comprehensive meta-analytic synthesis has been performed to date.</p><p><strong>Objective: </strong>To systematically compare the incidence of acute and late skin toxicity outcomes between prone and supine WBI in patients with early-stage breast cancer following breast-conserving surgery.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, and Scopus was conducted in accordance with PRISMA 2020 guidelines. Randomized controlled trials and comparative observational studies reporting skin toxicity outcomes for prone versus supine WBI were included. Dichotomous outcomes were pooled using random-effects models and expressed as risk ratios (RRs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic and Cochran's Q test.</p><p><strong>Results: </strong>Nine reports met the inclusion criteria (1128 enrolled patients). Because three reports (Mulliez et al., Veldeman et al., Vakaet et al.) derive from a single randomized trial and one retrospective cohort (De Langhe et al.) overlaps that centre's patients, no cohort contributed more than once to any pooled outcome. Using de-duplicated data and Hartung-Knapp-Sidik-Jonkman (HKSJ) random-effects models, prone positioning was not associated with a statistically significant change in any outcome. For moist desquamation, the nominally significant reduction observed in the original analysis was no longer statistically significant after removal of overlapping cohorts and application of HKSJ inference (two randomized trials; RR 0.57; HKSJ 95% CI 0.01-42.55; p = 0.34). No significant differences were found for Grade 2+ acute skin toxicity (RR 0.76; p = 0.37), acute pain (RR 0.75; nominally significant under DerSimonian-Laird [p = 0.04] but not under HKSJ [p = 0.29]), Grade 2 erythema/dermatitis (RR 0.84), Grade 1-2 toxicity (RR 1.05), or fibrosis (RR 0.76). A non-significant trend toward more mild (Grade 1) erythema was seen in the prone group (RR 1.72; HKSJ p = 0.16). Statistical heterogeneity was high for several outcomes.</p><p><strong>Conclusion: </strong>After accounting for multiple reports of the same randomized cohort and applying a more conservative variance estimator, the available evidence does not demonstrate a statistically significant effect of prone positioning on skin toxicity or other acute endpoints during adjuvant WBI. The apparent reduction in moist desquamation reported in the uncorrected analysis was not robust to these corrections. The evidence base is limited by few independent trials, clinical and methodological heterogeneity, and inconsistent toxicity reporting; adequately powered
背景:保乳手术后辅助全乳照射(WBI)是早期乳腺癌的标准治疗方法。患者在WBI期间的体位,俯卧还是仰卧,可能影响辐射引起的皮肤毒性的发生率和严重程度。然而,现有的研究报告了不一致的结果,迄今为止还没有进行全面的meta分析综合。目的:系统比较保乳术后早期乳腺癌患者俯卧位和仰卧位皮肤损伤急性和晚期皮肤毒性结局的发生率。方法:根据PRISMA 2020指南对PubMed、Embase和Scopus进行系统检索。随机对照试验和比较观察性研究报告了俯卧和仰卧WBI的皮肤毒性结果。采用随机效应模型对二分类结果进行汇总,并以95%置信区间(ci)的风险比(rr)表示。采用I²统计量和Cochran’s Q检验评估异质性。结果:9篇报道符合纳入标准(1128例入组患者)。由于三份报告(Mulliez等人,Veldeman等人,Vakaet等人)来自一项随机试验,而一项回顾性队列(De Langhe等人)与该中心的患者重叠,因此没有一个队列对任何汇总结果的贡献超过一次。使用重复数据和Hartung-Knapp-Sidik-Jonkman (HKSJ)随机效应模型,俯卧位与任何结果的统计学显著变化无关。对于湿脱屑,在去除重叠队列并应用HKSJ推断后,原始分析中观察到的名义上显著的减少不再具有统计学意义(两项随机试验;RR 0.57; HKSJ 95% CI 0.01-42.55; p = 0.34)。2+级急性皮肤毒性(RR = 0.76; p = 0.37)、急性疼痛(RR = 0.75; DerSimonian-Laird法名义上有显著性差异[p = 0.04],但HKSJ法无显著性差异[p = 0.29])、2级红斑/皮炎(RR = 0.84)、1-2级毒性(RR = 1.05)或纤维化(RR = 0.76)。易发组出现较轻度(1级)红斑的趋势不明显(RR 1.72; HKSJ p = 0.16)。有几个结果的统计异质性很高。结论:在考虑了同一随机队列的多个报告并应用更保守的方差估计后,现有证据表明,在辅助WBI期间,俯卧位对皮肤毒性或其他急性终点没有统计学上显著的影响。在未校正的分析中报道的湿脱屑的明显减少对这些校正并不可靠。证据基础受到少数独立试验、临床和方法学异质性以及不一致的毒性报告的限制;在专门推荐俯卧位以降低皮肤毒性之前,需要有标准化临床医生和患者报告的毒性结果的充分有力的随机试验。
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引用次数: 0
Nanosensitizer-based energy therapies for glioblastoma: A systematic review of a four-generation paradigm in evolving strategies (2020-2025). 基于纳米致敏剂的胶质母细胞瘤能量疗法:对进化策略中四代范式的系统回顾(2020-2025)。
IF 3.5 Q3 Medicine Pub Date : 2026-10-22 DOI: 10.1016/j.ctarc.2026.101498
S Abbasi, N Zahraie, A H Manaseri, A H Fathabadi, G Perota, S M H Afzali-Joibari, G H Tondro, H Haghighi, A Ketabi, N Sattarahmady

In oncology, glioblastoma multiforme (GBM) is considered a crucial challenge due to rapid drug resistance and the protective effects of the blood-brain barrier (BBB). Photodynamic therapy (PDT), photothermal therapy (PTT), and sonodynamic therapy (SDT) have emerged as promising approaches for GBM treatment, while limited energy penetration through the skull can restrict their effectiveness in intracranial tumors. The present systematic review aimed to evaluate studies on nanoparticle-based PDT, PTT, and SDT using online databases, including PubMed, Scopus, Web of Science, and Embase, from 2020 to 2025. Non-English studies, reviews, abstracts, book chapters, and retracted papers were excluded. A total of 663 records were initially identified, and 47 studies met the inclusion criteria. Based on the analysis of these studies, we observed a progressive shift in therapeutic strategies, categorized into four generations: (1) surface-limited ablation using near-infrared (NIR)-I thermal cytotoxicity; (2) multimodal synergistic therapies; (3) stimuli-responsive switch-on systems; and (4) deep-penetration modalities. The fourth generation is characterized by technologies, such as NIR-II lasers, X-ray-induced photodynamic therapy (X-PDT), low-intensity ultrasound (LIUS) and focused ultrasound, to overcome the depth barrier and promote immunogenic cell death. Nanoparticle-based GBM therapies are increasingly shifting toward multifunctional, BBB-targeted, and immune-engaging platforms. This trend highlights the need for multimodal, standardized, safe, and simpler designs.

在肿瘤学中,多形性胶质母细胞瘤(GBM)被认为是一个关键的挑战,因为它具有快速的耐药性和血脑屏障(BBB)的保护作用。光动力疗法(PDT)、光热疗法(PTT)和声动力疗法(SDT)已成为治疗GBM的有希望的方法,但通过颅骨的有限能量穿透限制了它们在颅内肿瘤中的有效性。本系统综述旨在利用PubMed、Scopus、Web of Science和Embase等在线数据库,对2020年至2025年基于纳米颗粒的PDT、PTT和SDT的研究进行评价。非英语研究、综述、摘要、书籍章节和撤回的论文被排除在外。最初共确定了663份记录,其中47项研究符合纳入标准。基于这些研究的分析,我们观察到治疗策略的逐步转变,分为四代:(1)使用近红外(NIR)-I热细胞毒进行表面有限消融;(2)多模式协同治疗;(3)刺激响应式开关系统;(4)深穿透模式。第四代以NIR-II激光器、x射线诱导光动力疗法(X-PDT)、低强度超声(LIUS)和聚焦超声等技术为特征,克服深度屏障,促进免疫原性细胞死亡。基于纳米颗粒的GBM治疗正日益转向多功能、bbb靶向和免疫参与平台。这一趋势凸显了对多式联运、标准化、安全和简化设计的需求。
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引用次数: 0
Non-coding RNA networks remodeling metastatic signaling in the lung cancer microenvironment: a focus on TGF-β signaling and its crosstalk with Wnt/β-catenin, HIF, Notch, integrin, and CXCL12/CXCR4 pathways. 肺癌微环境中非编码RNA网络重塑转移信号:聚焦TGF-β信号及其与Wnt/β-catenin、HIF、Notch、整合素和CXCL12/CXCR4通路的串扰
IF 3.5 Q3 Medicine Pub Date : 2026-10-19 DOI: 10.1016/j.ctarc.2026.101493
Tareq Nayef AlRamadneh, Jasur Rizaev, Amir Abdul Kadhim, K V Jamuna, Laxmidhar Maharana, Neeraj Bainsal, Divya Singhal, Djamila Polatova

Lung cancer mortality is driven largely by metastasis, which arises from tumor-intrinsic alterations and interactions within the tumor microenvironment (TME). Non-coding RNAs (ncRNAs), including miRNAs, lncRNAs, circRNAs, and extracellular vesicle-associated RNAs, regulate these interactions by modulating gene expression and intercellular signaling. This review examines ncRNA-mediated regulation of metastatic signaling in lung cancer, with particular emphasis on TGF-β signaling and its crosstalk with five additional pathways relevant to tumor dissemination: Wnt/β-catenin, hypoxia-inducible factor signaling, Notch, integrin/focal-adhesion signaling, and the CXCL12/CXCR4 axis. Particular attention is given to epithelial-mesenchymal transition, cancer stemness, extracellular matrix remodeling, angiogenesis, immune escape, and metastatic niche formation. The available evidence indicates that ncRNAs often act through interconnected regulatory circuits rather than isolated targets, and that their effects depend strongly on histological context, including LUAD, LUSC, other NSCLC subtypes, and SCLC, as well as on molecular background, cellular compartment, and experimental model. Findings derived from one histological or molecular setting should therefore not be assumed to apply uniformly across lung cancer. Hypoxia, cancer-associated fibroblasts, tumor-associated macrophages, and extracellular vesicles can alter ncRNA programs, while ncRNAs can reciprocally reshape these components. We also examine the potential translational relevance of ncRNA-based biomarkers and therapeutic strategies; however, most remain at the preclinical or exploratory stage and require further mechanistic, analytical, prospective, and clinical validation. Major barriers include delivery, target specificity, extracellular-vesicle standardization, reproducibility, and patient selection. A network-based interpretation may therefore provide a more realistic framework for understanding ncRNA contributions to lung cancer metastasis.

肺癌的死亡率主要是由转移引起的,转移是由肿瘤微环境(TME)内的肿瘤内在改变和相互作用引起的。非编码rna (ncRNAs),包括miRNAs、lncRNAs、circRNAs和细胞外囊泡相关rna,通过调节基因表达和细胞间信号传导来调节这些相互作用。本文综述了ncrna介导的肺癌转移信号的调控,特别强调了TGF-β信号及其与肿瘤传播相关的五个额外途径的串扰:Wnt/β-catenin,缺氧诱导因子信号,Notch,整合素/病灶粘附信号和CXCL12/CXCR4轴。特别关注上皮-间质转化、癌症干细胞、细胞外基质重塑、血管生成、免疫逃逸和转移生态位形成。现有证据表明,ncrna通常通过相互关联的调控回路而不是孤立的靶点起作用,它们的作用强烈依赖于组织学背景,包括LUAD、LUSC、其他NSCLC亚型和SCLC,以及分子背景、细胞室和实验模型。因此,不应假设从一种组织学或分子环境中得出的结果适用于所有肺癌。缺氧、癌症相关成纤维细胞、肿瘤相关巨噬细胞和细胞外囊泡可以改变ncRNA程序,而ncRNA可以相互重塑这些成分。我们还研究了基于ncrna的生物标志物和治疗策略的潜在翻译相关性;然而,大多数仍处于临床前或探索性阶段,需要进一步的机制、分析、前瞻性和临床验证。主要障碍包括递送、靶点特异性、细胞外囊泡标准化、可重复性和患者选择。因此,基于网络的解释可能为理解ncRNA在肺癌转移中的作用提供了一个更现实的框架。
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引用次数: 0
Targeted redox gene-expression profiling reveals shared and distinct expression patterns in HBV- and HCV-associated hepatocellular carcinoma. 靶向氧化还原基因表达谱揭示了HBV和hcv相关肝细胞癌中共享和独特的表达模式。
IF 3.5 Q3 Medicine Pub Date : 2026-10-19 DOI: 10.1016/j.ctarc.2026.101494
Halah Z Al-Rawi, Jihan Mesfer Al-Ghamdi, Hadeel Alsaran, Reham M Alahmadi, Budur Mohammed M Albariqi, Amna Ghazafi, Shaima F Al-Shammari, Afnan H Al-Ghamdi, Bdoor Ghareeb Alharbi, Rowa Jamal Aldeen Siddiq, Maaweya Awadalla

Background: Oxidative stress and redox dysregulation are important features of hepatocellular carcinoma (HCC), but their expression patterns in hepatitis B virus (HBV)- and hepatitis C virus (HCV)-associated HCC remain incompletely characterized. This study investigated redox-related gene expression and its potential functional and prognostic relevance.

Methods: A predefined 84-gene oxidative stress and redox-related quantitative real-time PCR array was used to profile 11 HCC samples (7 HCV-associated and 4 HBV-associated tumors) and 4 controls. Analyses included hierarchical clustering, gene-list overlap, functional enrichment, protein-protein interaction networks, gene-expression correlations, and exploratory survival analysis.

Results: Both HCC groups exhibited altered expression of genes associated with antioxidant defense, glutathione metabolism, mitochondrial redox regulation, and ferroptosis-related processes. In HCV-associated HCC versus controls, TXN, SPINK1, HSP90AA1, and DUSP1 showed increased expression. In HBV-associated HCC versus controls, GCLC, peroxiredoxins, CAT, and SOD1 showed increased expression. Eighteen genes were shared between comparison lists, including GPX4, GPX2, GPX3, PRDX1, PRDX5, TXN, GCLM, SOD2, and FTH1. Enrichment analyses implicated glutathione metabolism, oxidative stress, peroxisome function, and ferroptosis-associated processes. Network analysis identified GPX2, GPX3, GPX4, and SOD2 in a connected module. External exploratory survival analysis associated higher SPINK1 and HSP90AA1 expression with poorer overall survival.

Conclusions: These findings identify redox-related expression patterns warranting further investigation. Larger cohorts and functional studies are needed to establish etiological differences, ferroptosis susceptibility, and prognostic significance.

背景:氧化应激和氧化还原失调是肝细胞癌(HCC)的重要特征,但它们在乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)相关HCC中的表达模式尚未完全确定。本研究探讨了氧化还原相关基因表达及其潜在的功能和预后相关性。方法:使用预先定义的84个基因氧化应激和氧化还原相关的实时荧光定量PCR阵列分析11例HCC样本(7例hcv相关肿瘤和4例hbv相关肿瘤)和4例对照。分析包括层次聚类、基因表重叠、功能富集、蛋白质相互作用网络、基因表达相关性和探索性生存分析。结果:两组HCC均表现出与抗氧化防御、谷胱甘肽代谢、线粒体氧化还原调节和铁中毒相关过程相关的基因表达改变。与对照组相比,在hcv相关性HCC中,TXN、SPINK1、HSP90AA1和DUSP1的表达增加。在hbv相关的HCC中,与对照组相比,GCLC、过氧化物还毒素、CAT和SOD1的表达增加。比较列表间共有18个基因,包括GPX4、GPX2、GPX3、PRDX1、PRDX5、TXN、GCLM、SOD2和FTH1。富集分析涉及谷胱甘肽代谢、氧化应激、过氧化物酶体功能和死铁相关过程。网络分析在一个连接的模块中识别出GPX2、GPX3、GPX4和SOD2。外部探索性生存分析表明,较高的SPINK1和HSP90AA1表达与较差的总生存期有关。结论:这些发现确定了氧化还原相关的表达模式,值得进一步研究。需要更大的队列和功能研究来确定病因差异、铁下垂易感性和预后意义。
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引用次数: 0
Diagnostic accuracy of colposcopy-directed biopsy compared with LEEP histology: A retrospective cohort study. 阴道镜指导下活检诊断准确性与LEEP组织学比较:一项回顾性队列研究。
IF 3.5 Q3 Medicine Pub Date : 2026-10-19 DOI: 10.1016/j.ctarc.2026.101492
Katharina Kowoll, Jens Hachenberg, Jan Lennart Stalp, Peter Hillemanns, Lars Brodowski, Lena Steinkasserer

Background: Colposcopy-directed biopsy is widely used in the diagnosis of cervical dysplasia, but its accuracy is variable. Reliable detection of clinically significant lesions (CIN2+) is essential for appropriate treatment. This study assessed its diagnostic performance using histology after LEEP as the reference standard and explored factors associated with discrepancies.

Methods: 423 procedures were analyzed. Histological findings from colposcopy-directed biopsy were compared with the histology of the subsequent LEEP specimen. Diagnostic performance for CIN2+ was evaluated using sensitivity, specificity, predictive values, and accuracy; agreement was assessed using weighted Cohen's kappa. Subgroup analyses considered transformation zone (TZ) type, age, and menopausal status. Multivariable logistic regression assessed predictors of histopathological underestimation.

Results: Biopsy showed 97.0% sensitivity, 20.0% specificity, and 80.6% accuracy for CIN2+ detection. Exact histological agreement occured in 61.7% of procedures (κ = 0.31). Histopathological underestimation occurred in 12.3% and overestimation in 26.0%, indicating a tendency toward overestimation. Exact agreement decreased from 75.8% in TZ1 to 48.0% in TZ3 and from 65.2% in premenopausal to 48.4% in postmenopausal patients. Complete-case multivariable analysis included 227 procedures and 23 underestimation events. Compared with TZ1, TZ2 and TZ3 were independently associated with higher odds of underestimation other included covariates were not.

Conclusion: Colposcopy-directed biopsy shows high sensitivity but limited specificity for CIN2+ detection, with notable diagnostic discrepancies. Histological concordance was lower in patients with TZ 3 and in postmenopausal women, while TZ was independently associated with underestimation. These findings highlight the importance of considering anatomical and patient-related factors when interpreting biopsy results and planning clinical management.

背景:阴道镜指导下的活检广泛用于宫颈发育不良的诊断,但其准确性是可变的。可靠地检测临床显著病变(CIN2+)对于适当的治疗至关重要。本研究以LEEP后的组织学作为参考标准评估其诊断性能,并探讨差异的相关因素。方法:对423例手术进行分析。将阴道镜指导下活检的组织学结果与随后LEEP标本的组织学结果进行比较。使用敏感性、特异性、预测值和准确性评估CIN2+的诊断性能;使用加权科恩kappa评估一致性。亚组分析考虑了转化区(TZ)类型、年龄和绝经状态。多变量逻辑回归评估了组织病理学低估的预测因素。结果:活检对CIN2+检测的敏感性为97.0%,特异性为20.0%,准确性为80.6%。61.7%的手术完全符合组织学(κ = 0.31)。组织病理学低估率为12.3%,高估率为26.0%,有高估倾向。确切的一致性从TZ1的75.8%下降到TZ3的48.0%,从绝经前患者的65.2%下降到绝经后患者的48.4%。全病例多变量分析包括227个过程和23个低估事件。与TZ1相比,TZ2和TZ3与较高的低估几率独立相关,其他纳入的协变量则没有。结论:阴道镜指导下活检对CIN2+检测敏感性高,但特异性有限,诊断差异明显。TZ 3患者和绝经后妇女的组织学一致性较低,而TZ与低估独立相关。这些发现强调了在解释活检结果和规划临床管理时考虑解剖学和患者相关因素的重要性。
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引用次数: 0
The association of the gut microbiome with intermediate markers of breast cancer risk-mammographic density and blood steroid hormones-in the multiethnic cohort study. 多种族队列研究中,肠道微生物组与乳腺癌风险的中间标记物乳房x线摄影密度和血液类固醇激素的关系
IF 3.5 Q3 Medicine Pub Date : 2026-10-19 DOI: 10.1016/j.ctarc.2026.101497
Gertraud Maskarinec, Mae Anne Laxamana, Unhee Lim, Meredith A J Hullar, Johanna W Lampe, John A Shepherd, Adrian A Franke, Lynne R Wilkens, Loic Le Marchand

Introduction: The gut microbiota may influence breast cancer risk through different biologic pathways. This analysis examined the association of the gut microbial composition with percent mammographic density (PMD), a strong predictor of breast cancer risk.

Methods: Postmenopausal women in the Adiposity Phenotype Study, a cross-sectional subset of the Multiethnic Cohort, from five racial/ethnic groups, provided a stool sample. Extracted bacterial DNA was sequenced for the V1-V3 region of the 16S rRNA gene. Bioinformatic analysis determined alpha-diversity and the abundance of 10 phyla and 152 genera. PMD was assessed in routine mammograms taken before stool collection with a quantitative computer-assisted method. Blood levels of estrogen metabolites were assessed using standard assays. General linear models regressed PMD on gut microbial diversity, phyla, and genera while adjusting for relevant covariates.

Results: Of 649 women (69.1 ± 2.7 years), 311 had low (<15%) and 338 had high (>=15%) PMD. Whereas alpha diversity or phyla were not associated with PMD, 10 genera were nominally related to PMD (p < 0.05) but not after adjusting for multiple comparisons: 7 positively (Bifidobacterium, Blautia, Dialister, Eubacterium_fissicatena_group, Lachnospira, Lachnospiraceae_UCG-008, Lachnospiraceae_uncultured) and 3 inversely (Alistipes, Senegalimassilia, Eubacterium_oxidoreducens_group), potentially implicating estrogen metabolism and short-chain fatty acid production. All blood steroid metabolites were significantly related to PMD, but only SHBG was associated with 2 genera after Bonferroni adjustment.

Conclusions: The nominal associations detected in this analysis suggest that certain gut microbiota may be associated with PMD, a marker of risk but not a measure of breast cancer incidence, due to their ability to affect circulating hormones or SCFA production.

肠道微生物群可能通过不同的生物学途径影响乳腺癌的风险。该分析检查了肠道微生物组成与乳腺x线摄影密度百分比(PMD)的关系,PMD是乳腺癌风险的一个强有力的预测因子。方法:绝经后妇女在肥胖表型研究,多民族队列的横断面亚组,来自五个种族/民族,提供粪便样本。对提取的细菌DNA进行16S rRNA基因V1-V3区域的测序。生物信息学分析确定了10门152属的α -多样性和丰度。在收集粪便前用定量计算机辅助方法进行常规乳房x线照片评估PMD。使用标准测定法评估血液中雌激素代谢物的水平。在调整相关协变量的同时,一般线性模型回归了肠道微生物多样性、门和属的PMD。结果:649例女性(69.1 ± 2.7岁)中,311例PMD低(=15%)。尽管α多样性或门与PMD无关,但名义上有10个属与PMD相关(p )。结论:在本分析中检测到的名义关联表明,某些肠道微生物群可能与PMD有关,PMD是风险的标志,但不是乳腺癌发病率的衡量标准,因为它们能够影响循环激素或SCFA的产生。
{"title":"The association of the gut microbiome with intermediate markers of breast cancer risk-mammographic density and blood steroid hormones-in the multiethnic cohort study.","authors":"Gertraud Maskarinec, Mae Anne Laxamana, Unhee Lim, Meredith A J Hullar, Johanna W Lampe, John A Shepherd, Adrian A Franke, Lynne R Wilkens, Loic Le Marchand","doi":"10.1016/j.ctarc.2026.101497","DOIUrl":"https://doi.org/10.1016/j.ctarc.2026.101497","url":null,"abstract":"<p><strong>Introduction: </strong>The gut microbiota may influence breast cancer risk through different biologic pathways. This analysis examined the association of the gut microbial composition with percent mammographic density (PMD), a strong predictor of breast cancer risk.</p><p><strong>Methods: </strong>Postmenopausal women in the Adiposity Phenotype Study, a cross-sectional subset of the Multiethnic Cohort, from five racial/ethnic groups, provided a stool sample. Extracted bacterial DNA was sequenced for the V1-V3 region of the 16S rRNA gene. Bioinformatic analysis determined alpha-diversity and the abundance of 10 phyla and 152 genera. PMD was assessed in routine mammograms taken before stool collection with a quantitative computer-assisted method. Blood levels of estrogen metabolites were assessed using standard assays. General linear models regressed PMD on gut microbial diversity, phyla, and genera while adjusting for relevant covariates.</p><p><strong>Results: </strong>Of 649 women (69.1 ± 2.7 years), 311 had low (<15%) and 338 had high (>=15%) PMD. Whereas alpha diversity or phyla were not associated with PMD, 10 genera were nominally related to PMD (p < 0.05) but not after adjusting for multiple comparisons: 7 positively (Bifidobacterium, Blautia, Dialister, Eubacterium_fissicatena_group, Lachnospira, Lachnospiraceae_UCG-008, Lachnospiraceae_uncultured) and 3 inversely (Alistipes, Senegalimassilia, Eubacterium_oxidoreducens_group), potentially implicating estrogen metabolism and short-chain fatty acid production. All blood steroid metabolites were significantly related to PMD, but only SHBG was associated with 2 genera after Bonferroni adjustment.</p><p><strong>Conclusions: </strong>The nominal associations detected in this analysis suggest that certain gut microbiota may be associated with PMD, a marker of risk but not a measure of breast cancer incidence, due to their ability to affect circulating hormones or SCFA production.</p>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"49 ","pages":"101497"},"PeriodicalIF":3.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149243103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical response rates and adverse events associated with therapeutic tumor vaccines in lymphoma: A systematic review. 淋巴瘤治疗性肿瘤疫苗的临床反应率和不良事件:一项系统综述
IF 3.5 Q3 Medicine Pub Date : 2026-10-17 DOI: 10.1016/j.ctarc.2026.101485
Alireza Ghasemi, Mohammadreza Ghasemi, Mohammadreza Heidari, Saghar Hoseinzadeh, Maryam Samareh Salavatipour, Shirin Tavakoli, Shima Tavoosi, Amir Hossein Baghsheikhi, Mohammad Ahmadvand, Mahshid Akhavan Rahnama

Objectives: This study aims to evaluate the therapeutic efficacy and safety of tumor vaccine therapy in patients suffering from Hodgkin (HL) and Non-Hodgkin Lymphoma (NHL).

Methods: a systematic search was done in PUBMED, WOS, Embase and Scopus in order to identify relevant studies from their inception to February 8th, 2026. At first, title and abstract of retrieved records were checked for eligibility and then, a full-text evaluations were conducted. Then relevant data were extracted from eligible studies. Risk of Bias of Included studies were assessed using Cochrane ROB-2 and ROBINS-I tool. Proportions were estimated using the metaprop function of the R meta package with logit transformation and back-transformation for presentation. Because of substantial clinical and methodological heterogeneity, results were not pooled; instead, individual study estimates with 95% confidence intervals were presented in forest plots for qualitative comparison.

Results: Across studies of non-Hodgkin lymphoma, objective response rates varied from 6% to 44%, with complete response rates ranging from 0% to 28% and partial response rates from 6% to 29%. Response estimates varied across treatment-naïve, relapsed/refractory, and mixed-treatment populations, without a consistent pattern according to previous treatment status; most studies evaluated patients with active disease and predominantly indolent NHL. Grade 3-5 adverse events ranged from 0% to 19%, with no severe events reported in most studies, although treatment strategies and concomitant therapies differed substantially across cohorts. Only one study evaluated Hodgkin lymphoma, reporting an ORR of 66.7% (2/3), consisting entirely of partial responses, with no grade 3-5 adverse events. Given the marked clinical and methodological heterogeneity, findings were synthesized descriptively without pooled effect estimates.

Conclusion: Therapeutic tumor vaccines showed variable but measurable antitumor activity in NHL, with generally low rates of grade 3-5 adverse events across most studies. However, substantial clinical and methodological heterogeneity, small sample sizes, non-randomized designs, and highly limited evidence in HL prevent firm conclusions regarding efficacy or comparative effectiveness. Stronger comparative evidence from multicenter cohorts and registries with longitudinal follow-up, appropriate control groups, and propensity-score methods is needed to clarify vaccine-associated clinical responses and identify settings suitable for subsequent randomized evaluation.

目的:本研究旨在评价肿瘤疫苗治疗霍奇金(HL)和非霍奇金淋巴瘤(NHL)患者的疗效和安全性。方法:系统检索PUBMED、WOS、Embase、Scopus等数据库,筛选自建站至2026年2月8日的相关研究。首先对检索记录的标题和摘要进行合格性检查,然后进行全文评价。然后从符合条件的研究中提取相关数据。纳入研究的偏倚风险采用Cochrane rob2和ROBINS-I工具进行评估。使用R元包的metaprop函数估计比例,并使用logit变换和back变换进行表示。由于临床和方法的异质性,结果没有汇总;相反,在森林样地中给出了具有95%置信区间的个体研究估计值,用于定性比较。结果:在非霍奇金淋巴瘤的研究中,客观缓解率从6%到44%不等,完全缓解率从0%到28%不等,部分缓解率从6%到29%不等。反应估计在treatment-naïve、复发/难治性和混合治疗人群中有所不同,根据以前的治疗状态没有一致的模式;大多数研究评估的是活动性疾病和以惰性NHL为主的患者。3-5级不良事件从0%到19%不等,大多数研究中没有严重事件的报道,尽管治疗策略和伴随治疗在队列之间存在很大差异。只有一项研究评估了霍奇金淋巴瘤,报告的ORR为66.7%(2/3),完全由部分缓解组成,没有3-5级不良事件。考虑到明显的临床和方法学异质性,研究结果是描述性综合的,没有汇总效应估计。结论:治疗性肿瘤疫苗在NHL中显示出可变但可测量的抗肿瘤活性,在大多数研究中,3-5级不良事件的发生率普遍较低。然而,HL临床和方法学的异质性、小样本量、非随机设计和高度有限的证据阻碍了关于疗效或比较有效性的确切结论。需要来自多中心队列和纵向随访登记、适当的对照组和倾向评分方法的更有力的比较证据来阐明疫苗相关的临床反应,并确定适合后续随机评价的环境。
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引用次数: 0
Descriptive survival outcomes of fruquintinib-based PD-1 inhibitor strategies in advanced colorectal cancer reported as pMMR/MSS: a reconstructed-data analysis of prospective studies. 基于fruquininib的PD-1抑制剂策略治疗晚期结直肠癌的描述性生存结果报告为pMMR/MSS:一项前瞻性研究的重建数据分析。
IF 3.5 Q3 Medicine Pub Date : 2026-10-17 DOI: 10.1016/j.ctarc.2026.101496
Yao Ge, Ying Xia, Guo-He Lin, Chen Fu, Bo-Hua Kuang, Bi-Cheng Wang

Background: Fruquintinib is a standard later-line treatment for advanced colorectal cancer (aCRC) after oxaliplatin- and irinotecan-based chemotherapy. Prospective studies of fruquintinib-based programmed cell death protein-1 (PD-1) inhibitor strategies in aCRC reported as mismatch repair-proficient (pMMR) or microsatellite-stable (MSS) have yielded heterogeneous outcomes. We summarized observed survival and response outcomes using reconstructed individual-level records.

Methods: PubMed, Embase, Web of Science, and CENTRAL were searched from inception through January 26, 2026. Published Kaplan-Meier curves were digitized and converted to reconstructed individual-level time-to-event records with IPDfromKM in R. Merged Kaplan-Meier curves were treated as patient-weighted descriptive composites. Objective response rate (ORR) and disease control rate (DCR) were synthesized with random-effects models. Sensitivity analyzes excluded the prospective observational study and restricted the evidence to pharmacologic fruquintinib plus PD-1 doublets.

Results: Five prospective studies enrolled 150 patients; 147 contributed to reconstructed overall survival (OS) and progression-free survival (PFS) analyzes. Median OS and PFS were 11.7 and 5.4 months, respectively. Reconstructed duration of response included 14 responders from three studies and had a median of 8.8 months. In the aggregate response dataset (149 observations), ORR was 19% and DCR was 82%. In the doublet-only sensitivity analysis, median OS and PFS were 14.8 and 6.9 months, respectively.

Conclusion: These results descriptively summarize small, heterogeneous, uncontrolled studies and do not estimate a common treatment effect or the added benefit of PD-1 blockade. The overall composite should not be used as a uniform doublet benchmark or as the sole basis for clinical decisions or trial sizing.

背景:fruquininib是奥沙利铂和伊立替康基础化疗后晚期结直肠癌(aCRC)的标准后期治疗。基于fruquintinib的程序性细胞死亡蛋白-1 (PD-1)抑制剂策略在aCRC中被报道为错配修复精通(pMMR)或微卫星稳定(MSS)的前瞻性研究产生了不同的结果。我们利用重建的个人水平记录总结观察到的生存和反应结果。方法:检索PubMed、Embase、Web of Science和CENTRAL,检索时间为成立至2026年1月26日。已发表的Kaplan-Meier曲线被数字化并转换为重建的个体水平的时间到事件记录,其中ipd来自r中的km。合并的Kaplan-Meier曲线被视为患者加权描述性复合曲线。采用随机效应模型综合客观缓解率(ORR)和疾病控制率(DCR)。敏感性分析排除了前瞻性观察性研究,并将证据限制在药理学上的氟喹替尼加PD-1双药。结果:5项前瞻性研究纳入150例患者;147例患者参与了重建总生存期(OS)和无进展生存期(PFS)分析。中位OS和PFS分别为11.7和5.4个月。重建反应持续时间包括来自3项研究的14名应答者,中位数为8.8个月。在总响应数据集中(149次观察),ORR为19%,DCR为82%。在双敏感性分析中,中位OS和PFS分别为14.8个月和6.9个月。结论:这些结果描述性地总结了小型、异质性、非对照研究,并没有估计PD-1阻断的共同治疗效果或额外益处。整体组合不应作为统一的双重基准或作为临床决策或试验规模的唯一依据。
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引用次数: 0
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Cancer treatment and research communications
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