Chinese Journal of Cancer Research最新文献

Objective: Given the improved sensitivity of magnetic resonance imaging (MRI) for detecting ductal carcinoma in situ (DCIS), the omission of routine mammography (MG) or digital breast tomosynthesis (DBT) in high-risk breast cancer screening is under consideration. We aim to conduct a systematic review and meta-analysis to compare the screening sensitivity of MRI, MG and DBT for detecting DCIS in high-risk females.

Methods: PubMed, Embase, and Web of Science were searched for studies reporting the sensitivity of detecting DCIS in high-risk females up to July 02, 2025. Study quality was assessed with quality assessment of diagnostic accuracy studies-2 (QUADAS-2). Pooled sensitivity was estimated using a random-effects model, overall and stratified by age (<40 and ≥40 years old) and BRCA status (BRCA1 and BRCA2). Meta-regression was used to compare modalities.

Results: Seventeen studies (18,348 participants, 211 with DCIS) were included. MRI showed significantly higher pooled sensitivity [85%, 95% confidence interval (95% CI): 74%-94%] than MG (36%, 95% CI: 23%-50%; P<0.001). No DBT data were available. Combined MRI and MG yielded the highest sensitivity (99%, 95% CI: 97%-100%), but offered no significant gain over MRI alone in females <40 years old (P=0.091) and in BRCA1 mutation carriers (P=0.143).

Conclusions: MRI is more sensitive than MG for DCIS detection in high-risk females. In females <40 years old and BRCA1 mutation carriers, adding MG to MRI provides no additional diagnostic value. Considering the potential trade-offs, the routine use of MG in these subgroups should be carefully reconsidered.

Gastric cancer (GC) remains a significant public health burden in China, accounting for a high proportion of global incidence and mortality. Generally, the incidence and mortality of GC demonstrate marked demographic and geographic disparities in China, with higher rates in males, older adults and rural residents. Helicobacter pylori (H. pylori) infection serves as the main risk factor and contributes to approximately three-quarters of GC cases in China. Large-scale randomized controlled intervention trials in high-risk areas have provided robust evidence to support H. pylori eradication as an effective primary prevention strategy. Other established risk factors include high-salt diet and inadequate consumption of fresh fruits and vegetables. For secondary prevention, several national screening programs utilizing endoscopic examination have been conducted in high-risk populations, which were proven effective in early detection and mortality reduction. However, GC prevention and control in China still face great challenges, including increasing antibiotic resistance, limited screening coverage, and regional disparities in healthcare resources. Further efforts are urgently needed to integrate personalized risk prediction, family-based H. pylori control, and optimized cost-effective screening strategies for precision prevention to finally reduce the burden of GC.

The National Health Commission of the People's Republic of China Guidelines for Diagnosis and Treatment of Colorectal Cancer (2025 edition), based on evidence-based medicine, integrates cutting-edge international advances with Chinese clinical practice, and supplements and completes the previous versions. This version of the guidelines, retains the core diagnostic and treatment framework, highlights new contents such as "Surgical treatment of anal canal cancer" and "New technologies and advances in diagnosis and treatment", and systematically summarizes the core points in the surgical treatment, medical oncology treatment, radiation oncology treatment, imaging, and pathology treatment. It is designed to help clinicians quickly grasp the key points of the guidelines and promote the standardization, precision, and consistence of colorectal cancer diagnosis and treatment.

Breast cancer represents a significant and growing public health challenge in China, marked by a rising incidence and distinct variations across age groups and geographical regions. This review synthesizes recent evidence regarding the epidemiology, early detection, and early treatment in the Chinese context. We outline current patterns of disease burden and the spectrum of risk factors-both modifiable and non-modifiable. We note ongoing shifts linked to reproductive trends, lifestyle changes, and an aging population. Screening practices are increasingly evolving towards stratified, risk-adapted pathways. These approaches often combine mammography with adjunct imaging modalities such as ultrasound, digital breast tomosynthesis, or magnetic resonance imaging for selected populations, while artificial intelligence is under active investigation to enhance image interpretation and streamline workflow. Contemporary early management strategies emphasize breast-conserving surgery and selective axillary surgery, alongside the expanded application of hypofractionated and precision-targeted radiotherapy. Systemic therapy is increasingly guided by tumor subtype. In the adjuvant setting, molecular profiling and multigene assays are now routinely utilized to tailor treatment intensity to individual tumor biology, facilitating both treatment escalation or de-escalation where appropriate. Concurrently, in the neoadjuvant setting, research efforts within China and globally are focused on evaluating novel therapeutic regimens and biomarker-driven strategies to improve pathologic complete response rates and inform subsequent postoperative care. A consolidated understanding of these evolving themes is crucial for shaping effective clinical practice and health policies, ultimately supporting the goals of earlier diagnosis and improved patient outcomes in China.

Objective: Immune checkpoint inhibitor-related pneumonitis (ICIP) is a common and potentially life-threatening adverse event with non-specific symptoms. It is of significance to identify high-risk population of ICIP. However, existing prediction models for ICIP are often limited by their reliance on clinically inaccessible variables and homogeneous methodologies, hindering their clinical utility. This study aimed to develop a clinical risk-prediction model for ICIP in patients with gastrointestinal (GI) cancer based on four machine learning (ML) methods.

Methods: We conducted a retrospective analysis of data from GI cancer patients who received immune checkpoint inhibitors (ICIs) between 2018 and 2022 in Beijing Cancer Hospital. For each patient, 36 clinical indicators associated with pneumonia risk were gathered. The dataset was split into training and testing sets in a ratio of 7:3. Variable selection was first performed using Least Absolute Shrinkage and Selection Operator (LASSO) regression. Subsequently, four ML algorithms: logistic regression (LR), random forest (RF), Support vector machine (SVM), and Adaptive Boosting (AdaBoost), were employed to develop and validate ICIP prediction models. The models' performance was assessed using sensitivity, specificity, precision, F1-score, and the area under the receiver operating characteristic curve (AUC) value. The optimal cutoff point for the best model was determined and a web-based tool was developed based on it.

Results: We collected medical data from 1,101 GI cancer patients. Ten predictive variables were identified as significant: gender, age, treatment line, smoking index, drinking history, lung metastasis, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, hemoglobin, and albumin. After constructing and comparing four ML models, the RF model demonstrated best performance with an AUC of 0.899. The web-based tool for ICIP risk prediction is available at https://healthy.aistarfish.com/business/pneumonia-prediction/#/home.

Conclusions: We analyzed 36 clinical predictors of ICIP in 1,101 patients treated with ICIs, and 10 variables were included. The smoking index, albumin and hemoglobin emerged as novel predictors specific to GI cancers. Among the models constructed using four ML methods, the RF model showed the best performance. Additionally, a web-based tool was developed to facilitate the early clinical identification of populations at high risk of ICIP. Future directions include external validation of the model to enhance clinical usability.

Objective: A subset of patients with human epidermal growth factor receptor 2 positive (HER2+) breast cancer shows insensitivity to neoadjuvant therapy (NAT), often evidenced by imaging results indicating stable disease (SD) or progressive disease (PD), which may reflect intrinsic resistance to treatment. We aimed to investigate the factors associated with NAT insensitivity and its prognostic value in HER2+ breast cancer.

Methods: This study included consecutive patients with HER2+ breast cancer who received NAT consisting of chemotherapy combined with anti-HER2 monoclonal antibodies. NAT insensitivity was defined as SD or PD on the basis of treatment response evaluations. Statistical analyses were conducted on the collected clinical data, and HER2 heterogeneity was subsequently assessed.

Results: A total of 541 patients were included in the study, among whom 63 (11.6%) were categorized as NAT-insensitive group and 478 (88.4%) as NAT-sensitive group. Hormone receptor (HR) status (P=0.033), HER2 status (P=0.036) and anti-HER2 therapy (P=0.007) were associated with NAT sensitivity. NAT-insensitive group had a significantly shorter event-free survival (EFS) (3-year: 69.4% vs. 94.3%; P<0.001) and remained an independent prognostic factor according to Cox models [hazard ratio (HR)=8.637; 95% confidence interval (95% CI), 3.091-24.136; P<0.001]. Exploratory analysis revealed a greater proportion of HER2 heterogeneity in the NAT-insensitive group (19.4% vs. 4.3%; P=0.035).

Conclusions: HR positivity, HER2 2+/fluorescence in situ hybridization (FISH)+ status, and trastuzumab monotherapy are associated with NAT insensitivity, and NAT insensitivity independently indicates poor EFS. This study also highlights the need for prospective studies to clarify the role of HER2 heterogeneity and other mechanisms involved in predicting the response to NAT.

This comprehensive review integrates population-based registries, hospital databases and Global Burden of Disease data to describe the evolving leukemia burden in China from 2000 to 2022. The overall incidence has stabilized nationally, but the absolute number of cases continues to increase as the population ages. A bimodal age pattern persists, with acute leukemias clustering in young children and older adults, while chronic forms predominate in mid-to-late life, and males are consistently more affected by all subtypes. Rapid expansion of haploidentical hematopoietic stem cell transplantation has resulted in marked survival gains for both acute myeloid leukemia and acute lymphoblastic leukemia, and its seamless integration with molecularly targeted agents, venetoclax-based regimens and chimeric antigen receptor T-cell therapy has transformed acute leukemias into potentially curable diseases for an expanding proportion of patients. In parallel, universal access to tyrosine kinase inhibitors and standardized molecular monitoring have turned chronic myeloid leukemia into a manageable chronic condition, and survival of patients with chronic lymphocytic leukemia is improving as novel Bruton's tyrosine kinase and BCL-2 inhibitors diffuse into clinical practice. Tobacco, obesity, benzene and radon remain the principal modifiable drivers of leukemogenesis. Strengthening data completeness, widening equitable access to precision therapies and controlling these environmental risks are essential to sustaining the observed continuous improvement in leukemia patient survival and ensuring that ever more Chinese patients achieve a cure or durable disease control in the decades ahead.