World journal of clinical oncology最新文献

Background: Intrathyroidal thymic carcinoma (ITC) is a rare malignant epithelial tumour of thymic origin occurring within the thyroid. Histologically, it resembles thymic carcinoma, with squamous cell carcinoma being the most common subtype, and immunohistochemical staining typically exhibits features consistent with thymic neoplasms.

Case summary: We report the case of a 68-year-old woman who presented with a left-sided neck mass of one year's duration. And the neck lump had been gradually enlarging over the course of a year, reaching the size of a goose egg within six months. Thyroid ultrasound revealed a normally sized thyroid gland. A 3.9 cm × 3.4 cm × 2.7 cm hypoechoic lesion with irregular echogenicity was observed outside the capsule of the lower pole of the left lobe. The mass exhibited regular morphology, well-defined margins, and close adherence to the thyroid's lower pole. Microscopic examination revealed two distinct tumour cell populations: Squamous cell carcinoma and small cell carcinoma. Immunohisto-chemical staining demonstrated divergent differentiation - one population was positive for cluster of differentiation 5 and cluster of differentiation 117, supporting thymic origin, while the other exhibited neuroendocrine differentiation with synaptophysin and chromogranin A positivity. At eight months postoperatively, the patient remained recurrence-free on chemotherapy.

Conclusion: Based on these findings, the patient was diagnosed as ITC with both squamous cell and small cell carcinoma components. To date, nearly 100 cases of ITC have been reported in the literature. However, no prior reports of ITC exhibiting both squamous cell and small cell carcinoma components. This case report provides information on the microscopic morphological features of ITC with both squamous cell and small cell carcinoma components, which can help pathologists to expands the understanding of the pathological spectrum of the disease.

Perioperative fluorouracil, leucovorin, oxaliplatin and docetaxel is currently the standard chemotherapy for resectable gastric and gastroesophageal junction adenocarcinomas, based on the results of FLOT4 and ESOPEC trials. This regimen has demonstrated efficacy in tumor downstaging, enhancing the chances of curative resection, and ultimately improving the overall survival. However, despite these advances, the complete response rate in the perioperative setting remains below 10% to 15%, highlighting the need for more effective treatment strategies. Recent studies evaluating immunotherapy, such as the KEYNOTE-585 trial with pembrolizumab and the MATTERHORN trial with durvalumab, have shown promising preliminary results, including improved response rates and event-free survival. Nevertheless, these regimens are not yet considered the standard of care. This article explores the current landscape of perioperative treatments for gastric cancer and discusses future directions in this field.

Gastric cancer (GC) is one of the leading causes of cancer-related deaths worldwide and ranks among the top five most common malignancies. Helicobacter pylori (H. pylori) infection is recognized as the primary risk factor, although gastric carcinogenesis also reflects complex interactions among bacterial virulence factors, host genetics, and the gastric microbiome. H. pylori harbors well-characterized proteins such as CagA, VacA, BabA, and SabA that enable persistent infection and fuel tumor initiation. Recent high-quality evidence from randomized trials and meta-analyses provide strong support that H. pylori eradication therapy substantially reduces cancer risk-even in those with established precancerous lesions such as intestinal metaplasia or dysplasia. Additionally, emerging research indicate that H. pylori may influence the tumor immune microenvironment, such as through altering programmed death ligand 1 expression-which could affect immunotherapy outcomes. This review presents a cohesive and updated perspective on H. pylori-driven GC, summarizing bacterial virulence, host predispositions, microbiome interactions, epigenetic changes like DNA repair gene methylation, and evolving therapeutic implications, all while illuminating current scientific debates and emerging directions.

This article comprehensively reviews research progress in prostate cancer radiation therapy. It provides an overview of fundamental principles, encompassing the disease's epidemiology, pathological mechanisms, and radiation sensitivity, alongside technological advancements. The clinical application, technological progress, and efficacy evaluation of moderate hypofractionated radiation therapy and ultra hypofractionated radiation therapy are discussed. Diagnostic and monitoring techniques specific to radiation therapy are analyzed, alongside prevailing controversies and challenges. Finally, the review outlines future prospects, including novel radiotherapy techniques, multidisciplinary collaboration trends, and the evolving role of radiation within comprehensive treatment. The findings demonstrate continuous technological and clinical evolution in prostate cancer radiotherapy, yet emphasize the need for further exploration to optimize treatments and improve patient survival and quality of life.

Fibrosis is marked by the excessive accumulation of extracellular matrix (ECM) components, leading to tissue scarring and progressive loss of organ function. Myofibroblasts, which emerge during tissue repair, are specialized contractile cells exhibiting features of both fibroblasts and smooth muscle cells. Their expression of α-smooth muscle actin facilitates contractile activity, while their persistent activation and overproduction of ECM components contribute significantly to pathological wound contraction and fibrotic progression. Beyond ECM production, myofibroblasts play a significant role in the tumor microenvironment (TME) of various solid tumors. The TME is a complex network of immune cells, blood vessels, ECM components, and stromal cells like fibroblasts and myofibroblasts that surrounds and interacts with cancer cells, thereby influencing tumor growth, progression, and therapy responsiveness. Through these interactions, myofibroblasts modulate inflammation, angiogenesis, and tissue remodeling. Maintaining myofibroblast homeostasis is therefore crucial, as its disruption can drive the onset of chronic fibrotic conditions and malignancies. This review explores preclinical and clinical developments in targeting myofibroblasts in fibrotic and TME across various disease models, including hypertrophic scar, idiopathic pulmonary fibrosis, oral submucous fibrosis, cardiac fibrosis, and the desmoplastic stroma of pancreatic and breast cancers.

Background: Helicobacter pylori (H. pylori) infection is widely considered to be a major risk factor for gastric cancer, contributing to its development through the Correa cascade. Yin Yang 1 (YY1) is a transcription factor that acts as a promoter or suppressor of cancer progression. However, the role of YY1 in the inflammatory transformation associated with H. pylori-induced gastric cancer remains unclear.

Aim: To explore the expression of YY1 in gastric cancer and its impact on cancer progression with H. pylori infection.

Methods: H. pylori bacteria were cocultured with GSE1 cells, AGS cells, and SGC7901 cells, as well as in infected and xenograft mouse models. Expression of YY1, members of the Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) signaling pathway, and epithelial-mesenchymal transition (EMT)-related proteins in gastric cancer was examined using Western blotting, quantitative real-time polymerase chain reaction, and immunohistochemistry. Survival analysis was performed using the Kaplan-Meier method with the log-rank test. The role of YY1 in gastric cancer cell proliferation was further evaluated through in vitro and in vivo assays.

Results: YY1 was highly expressed in gastric cancer tissues and cells. Kaplan-Meier survival curves indicated that high YY1 expression correlated with a poor prognosis. YY1 expression showed a gradually increasing trend in H. pylori-induced gastritis and gastric tumors. In vivo and in vitro experiments demonstrated that H. pylori infection promoted phosphorylation of JAK2 and STAT3, thereby activating the EMT pathway, in which YY1 played a key role. YY1 and JAK2 interaction was validated by chromatin immunoprecipitation. YY1 knockdown or pharmacological inhibition reversed EMT and suppressed gastric cancer cell proliferation and metastasis.

Conclusion: These results suggest that YY1 plays an important role in progression of H. pylori-induced gastric cancer by activating EMT.

Malignant diseases in both children and adults are a worldwide public health priority with a high socioeconomic burden. Ectonucleoside triphosphate diphosphohydrolase 6 (ENTPD6) molecule exhibits divergent expression patterns across different cancers. Its increased expression in some tumors may allow them to escape anti-tumor immune responses, potentially by inducing an immunosuppressive tumor microenvironment and favoring a poorer prognosis. Conversely, in vivo, a mutated ENTPD6 gene may induce effective cytotoxic T cell responses, thereby reducing liver tumor size. Additionally, low expression of ENTPD6 has been related to chemotherapy resistance, whereas specific ENTPD6-derived neoepitopes may potentially enhance the efficacy of immunotherapy. This paper analyses the dual roles and clinical utility of ENTPD6 in cancer.

Background: Primary testicular lymphoma (PTL) is a rare, aggressive malignancy, representing a small fraction of testicular tumors and non-Hodgkin lymphomas, yet it is the most common testicular malignancy in older men. Diffuse large B-cell lymphoma (DLBCL), which is typically the aggressive subtype, dominates PTL and shows diffuse B-cell infiltration. Venous tumor thrombus, uncommon in lymphomas, is uniquely reported in this case of testicular DLBCL with gonadal vein involvement.

Case summary: A 62-year-old man presented with a two-month history of painless left testicular swelling and stiffness. Diagnostic imaging [ultrasonography, computed tomography (CT), and ¹⁸F-fluorodeoxyglucose positron emission tomography/CT (¹⁸F-FDG-PET/CT)] revealed bilateral testicular masses and a gonadal vein tumor thrombus (SUVmax 16.5). Left orchiectomy confirmed DLBCL with CD20, Bcl-2, and MUM1 positivity (Ki-67: approximately 80%). The disease was staged as Ann Arbor stage IVA (International Prognostic Index score 3, high-intermediate risk). The patient received Rituximab, Polatuzumab Vedotin, Cyclophosphamide, Epirubicin, and Prednisolone chemotherapy, completing the first cycle with good tolerability. No adverse events were reported, and follow-up is ongoing to assess long-term outcomes. This case highlights the diagnostic utility of ¹⁸F-FDG-PET/CT and the importance of multidisciplinary management in rare PTL presentations with tumor thrombus.

Conclusion: This case demonstrates the diagnostic complexities of PTL with gonadal vein tumor thrombus, underscoring the importance of considering lymphoma in elderly patients with testicular masses and venous involvement. A multi-disciplinary team including urologists, hematologists, and radiation oncologists is needed to ensure appropriate therapy.

Background: Cancer survivorship is a growing concern globally, yet few studies have explored the quality of life (QoL) outcomes among survivors in the Middle East, particularly in Saudi Arabia.

Aim: To assess QoL using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) and to evaluate the impact of demographic and clinical factors among Saudi cancer survivors.

Methods: We conducted a cross-sectional study of 102 adult cancer survivors recruited from a tertiary hospital in Jeddah, Saudi Arabia. Participants completed the WHOQOL-BREF, which assesses four QoL domains, including physical health, psychological health, social relationships, and environment. Univariate and multivariable robust linear regression models (Huber estimator) were used to identify QoL score predictors, adjusted for key sociodemographic and clinical variables.

Results: The mean participant age was 44.5 years; 72.5% of the participants were female. The mean domain scores were as follows: physical health was 3.05 ± 0.53, psychological health was 3.56 ± 0.79, social relationships was 3.39 ± 0.84, and environment was 3.29 ± 0.74. Socioeconomic and social vulnerability factors, including low income, rental housing, widowed/divorced marital status, and lower education, were independently associated with poorer QoL scores. Residents in rural settings had significantly lower scores in all domains.

Conclusion: Our findings reveal noticeable disparities in QoL among Saudi cancer survivors driven by socioeconomic and demographic factors. These insights underscore the need for context-sensitive survivorship programs in Saudi Arabia, with special attention to social support, mental health, and economic stability.