Oncology Reviews最新文献

Objective: To Compare the effects between thulium laser en bloc resection of bladder tumor (ERBT) and conventional transurethral resection of bladder tumor (TURBT) on catheter-related bladder discomfort (CRBD) in patients with bladder cancer.

Methods: Between January 2022 and December 2024, we retrospectively collected the demographic and clinical data for patients with bladder cancer. A total of 79 patients in the conventional TURBT group and 58 patients in the thulium laser ERBT group completed the study. Both demographic and outcome variables were recorded; and we compared the incidence and severity of CRBD at 1, 6 and 24 h postoperatively, score of postoperative pain at 1, 6 and 24 h and patient satisfaction at 24 h following the surgery.

Results: There were no significant differences in age, gender proportion, tumor multiplicity, tumor size and location, and duration of surgery between the two groups (P > 0.05). Pathological examination revealed that the ERBT had a higher rate of detrusor presence than TURBT (P = 0.04). The incidence and severity of postoperative CRBD were lower in ERBT group than TURBT group at 1 and 6h (P < 0.001), while there were no statistically significant difference between the two groups (P = 0.17) at 24 h. The VAS scores of postoperative pain were significantly lower in ERBT group than in TURBT group at 1 and 6 h postoperatively (P = 0.001 and P = 0.02, respectively). But at 24 h, there was no statistically significant difference (P = 0.08). As to postoperative patient satisfaction at 24 h, the result of ERBT group was significantly lower than TURBT group (P = 0.02). Additionally, the ERBT group had significantly less intraoperative blood loss and shorter postoperative irrigation duration (P = 0.001). No significant difference was found in the duration of indwelling catheter between the two groups (P = 0.07).

Conclusion: The results suggest that compared to conventional TURBT, thulium laser ERBT significantly reduce CRBD incidence and severity, lower postoperative pain, and improve postoperative patient satisfaction. However, as a single-center retrospective study, these findings require further validation by large-scale, prospective, multicenter trials.

Colorectal cancer (CRC) progresses through defined stages, from localized carcinoma in situ (Stage 0) to metastatic disease (Stage IV), with treatment strategies evolving from surgery in early stages to systemic therapies in advanced stages. Advances in biomarkers and genomic profiling have enabled personalized approaches, enhancing precision medicine. Nitric oxide (NO) plays a multifaceted role in CRC, acting as both a promoter and an inhibitor of cancer progression depending on its concentration, timing, and cellular context. At low concentrations, NO promotes angiogenesis, enabling tumor growth and metastasis. Conversely, high concentrations can exert anti-tumor effects, including the induction of cell death. Notably, its role in ferroptosis is biphasic: while high, exogenously delivered concentrations of NO can induce this iron-dependent cell death, lower, endogenously regulated levels can be protective by terminating lipid peroxidation. NO influences CRC by modulating the tumor microenvironment, mechanostress responses during metastasis, and signaling through extracellular vesicles (EVs), thereby aiding immune evasion. It also reprograms CRC cell metabolism, enhancing glucose utilization and mitochondrial activity to support growth in hypoxic conditions. The three nitric oxide synthases (NOS)-inducible NOS (iNOS), endothelial NOS (eNOS), and neuronal NOS (nNOS)-interact with hydrogen sulfide (H₂S) to regulate oxidative stress and tumor growth. Targeting NO-related processes, such as ferroptosis, metabolic adaptations, and immune modulation, offers promising therapeutic advances to improve CRC treatment outcomes. This review highlights the dual role of NO in CRC, with particular focus on its novel mechanisms in ferroptosis, metabolism, immune modulation, and tumor-microenvironment interactions.

The tumour-stroma ratio (TSR), which refers to the composition of stromal tissue and tumour epithelium of a malignant lesion, is gaining recognition as a promising biomarker in pathology. In 2018, recommendations for quantifying TSR in colorectal carcinoma were published, yet diverse quantification methods are still in use today. To assess the prognostic value of TSR, evaluate the impact of scoring variations, and explore efforts to automate TSR quantification, a scoping review was conducted. A total of 950 articles were identified through PubMed and Scopus, of which 76 met the inclusion criteria for this review. Of these, 56 employed manual scoring methods, while 20 utilised semi-automated or fully automated TSR quantification techniques. The TSR has been consistently identified as a strong prognostic indicator for disease-free survival. Its association with poor prognosis may be linked to its correlation with metastatic status, perineural invasion, and vascular invasion in stroma-high lesions. Variability in TSR scoring protocols was most evident in the selection of the region of interest and the type of histological specimen, both of which had a direct impact on final TSR scores. Moreover, significant inter-observer variability was observed in manual semi-quantitative TSR assessments, with Kappa scores ranging from 0.42 to 0.88. Automated TSR scoring pipelines have been proposed to standardise scoring protocols and reduce inter-observer variability. Deep learning models have demonstrated promising results, with pixel-wise and patch-wise accuracies exceeding 95%. Even though deep learning approaches have shown high performance, discrepancies remain, as evidenced by Kappa scores ranging from 0.239 to 0.472. In conclusion, the variation in TSR scoring protocols, along with a wide range of inter-observer variability, limits the broader clinical application of TSR. While automated TSR quantification methods show promise, they are still in the early stages, particularly in relation to region of interest selection and stratifying patients into risk categories. As these methods evolve, adjustments to TSR scoring cut-off values may be necessary to improve consistency. This scoping review highlights the prognostic significance of TSR in colorectal carcinoma while emphasizing the challenges posed by variability in scoring methods and the need for further advancements in automated quantification.

The colorectal cancer (CRC) screening landscape has rapidly evolved, introducing new technologies alongside established methods. The lack of head-to-head observational studies comparing these diverse options impairs clinicians' and patients' ability to make informed choices in CRC screening test selection. This manuscript aims to provide a comprehensive review of existing and emerging CRC screening technologies and develop a practical framework for informed decision-making. We conducted a systematic review of current literature on CRC screening methods, including colonoscopy, fecal immunochemical test (FIT), multi-target stool DNA test (mt-sDNA), the next-generation multi-target stool DNA test, multi-target stool RNA test (mt-sRNA), and blood-based tests. We summarized performance characteristics, adherence rates, follow-up colonoscopy rates, accessibility, and costs for each method. Our review revealed significant variations in test performance, patient adherence, and implementation factors across screening modalities. Blood-based tests showed promise in terms of patient acceptance but currently have lower sensitivity for early-stage cancers with a higher participant adherence when screening navigation is provided. Our review led to the development of a comprehensive framework for evaluating CRC screening options, addressing the critical need for informed decision-making in this area. The framework encompasses five key dimensions: test performance (sensitivity and specificity for CRC and precancerous lesions), patient considerations (invasiveness, preparation, and location preferences), adherence and follow-up (real-world rates and diagnostic colonoscopy completion rates), accessibility and cost (insurance coverage, out-of-pocket expenses, and system integration), and screening interval (recommended frequency and long-term impact). By synthesizing data, the framework enables healthcare providers and patients to navigate the complex landscape of screening options, facilitating personalized recommendations tailored to individual risk factors, preferences, and healthcare system constraints. Future research should validate this framework in diverse clinical settings and update it as new technologies emerge, ensuring continued improvement in CRC screening participation, effectiveness, and outcomes.

Background and aims: Liquid biopsy offers a minimally invasive tool to detect actionable mutations, monitor minimal residual disease (MRD), and guide therapy in gastrointestinal (GI) cancers. We critically review the clinical utility of circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), and small extracellular vesicles (sEVs) across GI malignancies and propose a framework for their integration into clinical practice.

Methods: We synthesized evidence from over 200 studies, including prospective trials and translational research, to assess diagnostic accuracy, prognostic value, and clinical actionability of each biomarker type in esophageal, gastric, colorectal, pancreatic, hepatocellular, and biliary cancers.

Results: ctDNA has shown strong potential for MRD detection and treatment monitoring, particularly in colorectal and pancreatic cancer. CTCs offer insights into metastatic risk and therapeutic resistance, while sEVs provide molecular cargo relevant to immunomodulation and disease progression. Emerging microfluidics and AI-driven multi-omics approaches may overcome current limitations.

Conclusion: The integration of liquid biopsy technologies into GI oncology holds promise for early detection and precision therapy. We propose a five-phase clinical roadmap and outine the key research gaps that need to be addressed before widespread implementation in routine care.

Osteosarcoma is the most common primary malignant bone tumor, accounting for approximately 20% of all primary malignant bone tumors, and predominantly affects adolescents. The current standard treatment involves a multimodal approach combining neoadjuvant chemotherapy, surgical resection, and postoperative adjuvant chemotherapy. However, patient responses to chemotherapy vary significantly, with response rates (defined as patients achieving ≥90% tumor necrosis) ranging from 30% to 60%. Chemotherapy sensitivity is one of the most critical prognostic factors, and this heterogeneity underscores the importance of predictive tools for optimizing individualized treatment and improving clinical outcomes. In recent years, radiomics has emerged as a revolutionary paradigm in medical imaging analysis. By extracting high-throughput, deep-layer feature information from medical images, it provides a novel technical pathway for quantitative tumor phenotyping. Advanced computer vision algorithms enable the automated extraction of thousands of quantitative metrics-including morphological (shape features), intensity (first-order statistics), and texture (second- and higher-order features)-from multimodal imaging data such as Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and 18F-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET/CT) These features not only precisely characterize tumor heterogeneity and the microenvironment but also overcome the subjectivity and reproducibility limitations of traditional manual image interpretation. Leveraging these advantages, radiomics has demonstrated significant value in predicting neoadjuvant chemotherapy efficacy in osteosarcoma.

Objective: Esophageal cancer (EC) ranks as the sixth leading cause of cancer-related deaths globally, with over 500,000 new cases annually. Understanding trends in individuals over 60 is critical for enhancing treatment and the success of early diagnosis and screening.

Materials and methods: This study analyzed global, regional, and national trends in EC management among individuals aged 60 years and older, spanning from 1990 to 2021, utilizing data from the Global Burden of Disease Study 2021. We employed the integrating differential equations to enhance the accuracy of incidence, prevalence, mortality, and Disability-Adjusted Life Years (DALYs). The Bayesian Age-Period-Cohort (BAPC) model was also used to forecast future trends up to 2050.

Results: Our findings indicate significant shifts in the EC burden among those over 60, with a notable increase in absolute numbers from 1990 to 2021, despite a decline in age-standardized rates. The incidence rose by 185%, while the age-standardized prevalence rate decreased by 17.02%. Socioeconomic factors, indicated by the Social Demographic Index, revealed varying trends across different regions and income levels, highlighting the influence of economic status on EC outcomes.

Conclusion: Analysis indicates varying trends across different regions. Behavioral risk factors, particularly smoking and alcohol use, significantly contribute to the burden of EC, especially among males. Projections suggest that despite declining age-standardized rates, the absolute number of cases, deaths, and DALYs will continue to rise due to population growth and aging, highlighting the ongoing global challenge of EC.

Adriamycin (ADM) resistance remains a major clinical obstacle in breast cancer chemotherapy, driven by complex mechanisms including enhanced drug efflux, apoptosis inhibition, and protective autophagy. This review explores a novel regulatory axis centered on eukaryotic initiation factor 3b (eIF3b) and its interplay with autophagy and the Wnt/β-catenin signaling pathway in ADM resistance. Emerging evidence indicates that eIF3b, a crucial subunit of the translation initiation complex, is significantly overexpressed in ADM-resistant breast cancer tissues and cell lines. Crucially, our preliminary experimental findings demonstrate that downregulation of eIF3b suppresses autophagy and concurrently sensitizes resistant breast cancer cells to ADM. While protective autophagy is a well-established resistance mechanism, and the Wnt/β-catenin pathway significantly contributes to multidrug resistance, the specific role of eIF3b and its potential crosstalk with these pathways in ADM resistance is poorly understood. This review synthesizes current knowledge, highlighting the strong evidence suggesting eIF3b acts as an upstream regulator of autophagy to promote ADM resistance. Furthermore, it discusses the potential involvement of the Wnt/β-catenin pathway in this regulatory network, and proposes several hypothetical models of interaction among eIF3b, autophagy, and Wnt/β-catenin signaling. Elucidating the precise molecular mechanisms by which eIF3b drives autophagy and potentially interacts with Wnt/β-catenin holds significant promise for identifying novel therapeutic targets to overcome ADM resistance and improve breast cancer treatment outcomes. Ultimately, targeting the eIF3b-autophagy-Wnt/β-catenin axis could provide a innovative translational strategy to reverse chemoresistance in breast cancer patients.

Lung cancer associated with cystic airspaces (LCCAs) is a distinct subtype of lung cancer defined by its unique radiological characteristics. It is increasing in prevalence but is often misdiagnosed. The constantly emerging radiological classification systems help characterize LCCAs and guide certain treatment methods. Compared to non-LCCAs, LCCAs are more likely to be associated with an invasive nature. The natural progression of LCCAs involves the thickening of cyst walls and the emergence of solid nodules, which are indicative of tumor progression. Despite their aggressive features, the overall prognosis of LCCAs was similar to non-LCCAs this review, we aim to systematically address the current understanding of LCCAs, including the epidemiology, radiologic classification, pathology, molecular characteristics, disease progression, and survival prognosis, highlighting the need for further research to standardize the diagnosis and treatment of LCCAs and to better understand their mechanisms of development.