Frontiers in Oncology最新文献

Objective: This study investigated the association between Helicobacter pylori (H. pylori) infection and the expression of CD163⁺ and CD86⁺ tumor-associated macrophages (TAMs) in colorectal adenoma (CRA) and colorectal cancer (CRC) tissues.

Methods: Immunohistochemistry (IHC) was used to evaluate the expression of CD163⁺ and CD86⁺ TAMs isolated from colorectal tissues, Multiplex immunofluorescence (mIF) co-staining was employed to identify CD68⁺CD163⁺ and CD68⁺CD86⁺ TAMs, and the ¹⁴C-urea breath test (UBT) was used to detect H.pylori infection.

Results: The progression of colorectal lesions was significantly associated with increased expression of CD163⁺ and CD86⁺ TAMs, as well as H.pylori infection (all P < 0.05). The expression of CD163⁺ and CD86⁺ TAMs were positively correlated with each other and with the severity of colorectal lesions (all P < 0.001). Patients with H.pylori infection exhibited significantly higher expression of both TAM subsets compared with non-infected individuals (all P < 0.05). Multiple linear regression analysis showed that in colorectal adenomas measuring ≥ 1 cm, expression of CD163⁺ and CD86⁺ TAM was significantly greater than in adenomas <1 cm (P < 0.05), Expression of CD163⁺ TAM was notably higher in obese patients with CRC. Multiplex immunofluorescence (mIF) quantification revealed significantly increased densities of both CD68⁺CD86⁺ and CD68⁺CD163⁺ TAMs, and a higher CD68⁺CD163⁺/CD68⁺CD86⁺ ratio in colorectal cancer (CRC) (all P < 0.001).

Conclusions: The expression of CD68⁺CD163⁺ and CD68⁺CD86⁺ TAMs change dynamically with the progression of colorectal lesions. These changes are influenced by H.pylori infection, adenoma size, tumor differentiation, and patient metabolic status.

Introduction: Electroporation (EP) is a technique that transiently increases the permeability of the cell membrane through the application of high-voltage electric pulses, facilitating the intracellular delivery of therapeutic agents or the selective ablation of cells. Combination of EP with cytotoxic drugs-most commonly bleomycin or cisplatin-is termed electrochemotherapy (ECT), which markedly enhances drug efficacy and permits targeted, locally controlled treatment with reduced systemic exposure. Currently, in addition to microsecond (µs) pulses, nanosecond (ns) pulses are being proposed for clinical use to mitigate certain ECT-associated side effects. However, achieving robust permeabilization with nsPEF typically requires higher electric fields. Nisin is a polycyclic antibacterial peptide with anticancer potential that can be leveraged in this context.

Methods: To date, the permeabilizing properties of nisin have been employed alongside an external electric field exclusively in bacterial systems and artificial membranes. In this study, we investigated the impact of nisin on membrane permeabilization, resealing, and viability of 4T1 breast cancer cells exposed to microsecond and nanosecond electric pulses of varying field strengths and pulse frequencies.

Results: Across all experimental conditions, nisin reduced the threshold voltage necessary for effective permeabilization and increased treatment-induced cell mortality.

Discussion: Since nisin is non-toxic by itself, it represents a promising candidate for electrochemotherapy, potentially supporting its wider clinical application in the future.

Background: Dyspareunia and vaginal stenosis are common complications in gynecological cancer survivors. Despite the widespread use of passive vaginal dilator therapy, physiotherapy interventions like oncological perineal massage (MPO^®) have not been thoroughly evaluated.

Objective: Tis study aims to compare the effectiveness of MPO^® perineal massage versus standard passive vaginal dilator therapy in managing dyspareunia, vaginal stenosis, sexual function, and quality of life in women with gynecological cancer.

Methods: A randomized controlled trial involving 35 women (MPO^® group: n = 18; control group: n=17) was conducted. The participants underwent either MPO^® massage or passive dilator therapy for 10 weeks, with assessments at baseline (T0), mid-treatment (T1), post-treatment (T2), and 6-month follow-up (T3). Outcomes included pain (VAS), vaginal stenosis (CTCAE 5.0), sexual function (FSM-2), and quality of life (EORTC QLQ-C30).

Results: The MPO^® group demonstrated significantly greater reductions in vaginal pain (median VAS: 8.5 at T0 to 0 at T3, p<0.001), with improvements also seen in vaginal stenosis (absence/presence at T3: 16/2 vs. 3/14 in controls, p<0.001), sexual function (notably lubrication, penetration ease, and satisfaction), and quality of life (QLQ-C30 median score: 32.5 at T0 to 30 at T3 in MPO^® vs. 35 to 32 in controls, p<0.001).

Conclusion: Oncological perineal massage (MPO^®) significantly improved pain, vaginal stenosis, sexual function, and quality of life in gynecological cancer survivors compared to passive dilator therapy. These findings support incorporating manual therapy techniques in comprehensive survivorship care in this population.

Clinical trial registration: ClinicalTrials [https://clinicaltrials.gov/study/NCT06432998], identifier NCT06432998.

This article reports an extremely rare case of a 31-year-old pregnant woman diagnosed with large cell neuroendocrine carcinoma (LCNEC) of the cervix complicated by syndrome of inappropriate antidiuretic hormone secretion (SIADH). Admitted at 35⁺¹ weeks gestation due to vaginal bleeding, she was diagnosed with cervical LCNEC and pelvic lymph node metastasis. Following cesarean delivery, she developed severe hyponatremia (as low as 92 mmol/L) leading to coma during chemotherapy, meeting the criteria for SIADH. The hyponatremia was successfully corrected with the selective vasopressin V2 receptor antagonist tolvaptan. The patient subsequently achieved complete remission (CR) after concurrent chemoradiotherapy. However, the disease recurred with multiple metastases six months later. Despite multiple lines of therapy, she succumbed to multiple organ failure 19 months after initial diagnosis. This case highlights the highly aggressive nature and poor prognosis of LCNEC complicated by SIADH during pregnancy. Tolvaptan proved effective for the associated refractory hyponatremia but required careful monitoring to avoid sodium overcorrection. Dynamic serum sodium monitoring may serve as a potential biomarker for tumor recurrence. A review identified deficiencies in the management, including initial insufficient investigation into the cause of hyponatremia, aggressive fluid therapy exacerbating the condition, and delays in multidisciplinary collaboration and systemic therapy. This case underscores the critical importance of multidisciplinary collaboration and early, aggressive systemic treatment in managing such complex and rare malignancies.

Background: Fertility preservation is a critical aspect of care for young breast cancer (BC) patients undergoing gonadotoxic treatments. BRCA mutation and hormone receptor (HR) status influence tumor biology and treatment outcomes. This study evaluated the impact of BRCA mutation and HR status on fertility preservation outcomes in BC patients.

Methods: PubMed, Embase, Scopus, and Web of Science databases were searched for publications from inception to March 31, 2025 that report on fertility preservation outcomes stratified by BRCA mutation or HR status. Primary outcomes included the number of retrieved oocytes, maturation rates, and ovarian reserve indices such as anti-Müllerian hormone (AMH) levels and antral follicular count (AFC). Random-effects meta-analyses were performed.

Results: Thirteen studies involving approximately 1,654 participants were included in the meta-analysis. Patients with no BRCA mutations reported significantly higher mature oocytes (MD: -1.48, 95% CI: -2.63 to -0.34) compared to those with BRCA mutations and non-significant total oocyte yield (MD: -1.37, 95% CI: -3.13 to 0.40). AFC and AMH levels showed no significant intergroup differences. Additionally, estrogen receptor (ER)-positive patients exhibited better ovarian response, with higher AFC (MD: 1.37, 95% CI: 0.48 to 2.26) and greater oocyte yield (MD: 1.35, 95% CI: 0.67 to 2.02).

Conclusion: Our results show that BRCA mutations may be associated with significantly diminished mature oocyte production during fertility preservation in BC patients. On the contrary, ER-positive status seems to be associated with high AFC and oocyte yield indicating a more advantageous ovarian response. The present findings are from a limited number of heterogenous studies and hence must be interpreted with caution.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42025641361.

Background: Colorectal cancer during pregnancy is rare and poses significant challenges for maternal and fetal care. Postoperative nursing interventions are essential to optimize recovery and prevent complications.

Case presentation: A 33-year-old primigravida (G1P0) at 29⁵ weeks' gestation presented with abdominal distension, lower back pain, anorexia, and fatigue. Imaging and laboratory tests revealed right ascending colon wall thickening, hepatic lesions, fecal occult blood positivity, elevated AFP (162.4 IU/mL) and CA125 (64.5 U/mL), and severe anemia. She underwent cesarean section with right hemicolectomy, D3 lymph node dissection, and partial hepatectomy. Postoperative nursing care included pain management via patient-controlled analgesia, parenteral and oral nutrition, fluid and electrolyte monitoring, drainage tube care, early mobilization, fever surveillance, deep vein thrombosis prophylaxis, psychological support, and maternal-neonatal separation management.

Outcome: The patient recovered progressively without subjective complaints. No incision infection, vaginal fluid leakage, or mastitis occurred. The surgical incision healed with Grade A outcome, and she was discharged in stable condition.

Conclusion: This case demonstrates the effectiveness of integrated, evidence-based postoperative nursing strategies in managing colorectal cancer during late pregnancy, providing guidance for similar complex cases.

Background: Sarcoma, a rare and highly heterogeneous malignant neoplasm originating from mesenchymal tissues, is broadly classified into bone sarcoma and soft tissue sarcoma depending on where they occur. Patients with advanced or metastatic sarcomas face a poor prognosis. Conventional chemotherapy regimens demonstrate limited efficacy with substantial adverse effects, and therapeutic options remain scarce for those experiencing chemotherapy failure or intolerance. The development of tyrosine kinase inhibitors has brought the treatment of sarcoma into a new stage. As a multi-target tyrosine kinase inhibitor, anlotinib exerts antitumor effects through dual mechanisms of anti-angiogenesis and direct tumor cell proliferation inhibition. While it has been increasingly reported to treat bone and soft tissue sarcoma with promising efficacy, there has been no systematic analysis of this application.

Methods: PubMed, Embase, the Cochrane Library, Web of Science, Vip (China), Cnki (China), WanFang (China), and SinoMed (China) databases were systematically searched for relevant studies, published from the inception of each database to July 12, 2025, without language restrictions. The primary outcomes included the objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and adverse events (AEs). These data were extracted and analyzed using STATA 17.0 software.

Results: A total of 16 studies with 787 participants were included in this meta-analysis. In terms of clinical efficacy, the pooled outcomes indicated that ORR and DCR were 8.8% (95%CI: 6.2%-11.7%) and 70.7% (95%CI: 64.8%-76.2%), respectively. Median PFS ranged from 2.7 to 12.4 months, with a pooled result of 6.68 months (95%CI: 5.37-7.98). Median OS ranged from 11.4 to 42 months, with a mean of 19 ± 9.5 months. Furthermore, the 3-, 6-, and 9-month PFS rates were 71.1%, 48.4%, and 32.0%, respectively. The 6- and 12-month OS rates were 85.7% and 67.8%, respectively. With regard to clinical safety, the three most common all-grade treatment-related adverse events associated with anlotinib were hand-foot syndrome (34.7%), hypertension (32.4%), and pharyngalgia (30.6%). However, the incidence of grade 3-4 adverse events was relatively low and manageable; for example, hypertension (7.9%), hand-foot syndrome (2.9%), and pneumothorax (3.0%).

Conclusions: Based on the evidence provided by this meta-analysis, anlotinib demonstrates promising clinical efficacy and a favorable safety profile in patients with advanced bone and soft tissue sarcomas, although additional high-quality clinical studies are required to further evaluate its properties and toxicity.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251103981, PROSPERO.

Background: Prostate cancer is a leading malignancy among men globally and continues to be a growing concern in Kazakhstan, where evidence regarding its long-term epidemiological trends is limited.

Objectives: This study seeks to assess national and regional trends in prostate cancer incidence, stage distribution, and morphological verification in Kazakhstan from 2005 to 2024.

Methods: A nationwide observational study utilizing registry data from the Unified Nationwide Electronic Health System was performed. Incident cases (ICD-10 code C61) were examined according to age, geographical region, and stage at diagnosis. The incidence rates were adjusted to the WHO World Standard Population (2000-2025) by age. Joinpoint regression was used to look at temporal trends, and it showed the annual percent change (APC) and the average annual percent change (AAPC) with 95% confidence intervals.

Results: From 2005-2024, 21,756 prostate cancer cases were recorded, with a mean age at diagnosis of 69.8 years. The age-standardized incidence rate (ASR) increased from 11.9 to 20.7 per 100,000 men (APC = +2.6%, p = 0.002). Four distinct periods were identified: an early decline (2005-2008), a sharp rise (2008-2016), a downturn (2016-2020), and a renewed increase (2020-2024). Age-specific incidence was negligible below 50 years, peaking at 75-79 years (228.6 per 100,000). Regional analyses revealed heterogeneous trends: monotonic increases in Atyrau, Aktobe, and Almaty (region), contrasted by boom-dip-rebound profiles in Karaganda, Pavlodar, and Almaty City. The proportion of early-stage (I-II) cases rose from 32.8% to 56.9%, while stage III declined from 49.7% to 22.9%; stage IV increased slightly (17.3% → 20.2%). Morphological verification improved nationally (mean ≈ 92%) and plateaued after 2015.

Conclusions: Kazakhstan shows an increase in prostate cancer cases, with more cases being diagnosed at an earlier stage but still a lot of cases being diagnosed at a later stage. This is probably due to the PSA screening program from 2013 to 2017, changes in policy since then, and problems with diagnosis during the pandemic. To get better results, we need to improve early detection, timely biopsy pathways, and connections to mortality and survival data.

Purpose: To explore the differences in apparent diffusion coefficient (ADC) values based on the primary tumor and sentinel lymph node (SLN) for predicting N stages of gastric cancer (GC).

Methods: One hundred and sixty histopathologically confirmed GC patients between April 2021 and October 2024 were prospectively recruited. Preoperative DW-MRI was performed, and ADC values from primary tumors (ADC_T) and SLNs (ADC_LN), along with their relative ratios (rADC_T, rADC_LN), were measured. Differences in these parameters across N stages were analyzed using the Kruskal-Wallis test. Receiver operating characteristic analysis was used to evaluate their diagnostic performances for predicting N0 vs. N1-3 stages, N0 + 1 vs. N2 + 3 stages, and N0 + 1 + 2 vs. N3 stages.

Results: Significant differences were observed in ADC_T, rADC_T, ADC_LN, and rADC_LN values across N stages (all p < 0.001). The AUC values of ADC_T, rADC_T, ADC_LN, and rADC_LN for predicting N0 vs. N1 + 2 + 3 stages were 0.753, 0.727, 0.782, 0.792, respectively. The AUC values of ADC_T, rADC_T, ADC_LN, and rADC_LN for predicting N0 + 1 vs. N2 + 3 stages were 0.776, 0.767, 0.844, 0.837, respectively. The AUC values of ADC_T, rADC_T, ADC_LN, and rADC_LN for predicting N0 + 1 + 2 vs. N3 stages were 0.797, 0.792, 0.857, 0.848, respectively.

Conclusions: Both primary tumor- and SLN-derived ADC values can effectively differentiate N stages among patients with GC. SLN-based ADC parameters exhibit superior diagnostic performance compared to primary tumor-based measurements in stratifying N-stage progression.