Background and purpose:Modified radical mastectomy is an important approach for treating breast cancer,but the risk of postoperative incision infection rate is relatively high,which can seriously affect the treatment outcome and prognosis of these patients.This study aimed to investigate the etiological characteristics,related risk factors and changes of serum inflammatory factors such as procalcitonin(PCT),C reactive protein(CRP),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)in patients undergoing modified radical mastectomy.Methods:The clinical data of breast cancer patients admitted to the Third People's Hospital of Zhengzhou from February 2019 to February 2022 were analyzed retrospectively.The pathogenic bacteria distribution and related risk factors of postoperative incision infection and the changes of serum inflammatory factors such as PCT,CRP,TNF-α and IL-6 were explored.This study has been approved by the Medical Ethics Committee of the Third People's Hospital of Zhengzhou(No.:2025-04-014-K01)and acquired the informed consent.The Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)checklist was followed for this case control study.Results:A total of 128 patients were enrolled in this study.All patients underwent modified radical mastectomy were divided into infected group(n=22)and non-infected group(n=106)according to whether incision infection occurred after surgery.The incision infection rate after modified radical mastectomy was 17.19%(22/128).Twenty-six strains of pathogenic bacteria were isolated and cultured from 22 patients with postoperative incision infection.Among these,16 strains were Gram-positive,accounting for 61.54%(16/26),mainly staphylococcus aureus and enterococcus faecalis.There were 10 Gram-negative strains,accounting for 38.46%(10/26),mainly escherichia coli and pseudomonas aeruginosa.The influencing factors of incision infection after modified radical mastectomy included preoperative neoadjuvant chemotherapy,intraoperative blood loss≥300 mL,postoperative drainage volume≥800 mL,drainage time≥7 d,albumin＜35 g/L,and white blood cell count＜4×109/L(P＜0.05).Multivariate logistic regression analysis showed that preoperative neoadjuvant chemotherapy,blood loss≥300 mL,postoperative drainage volume≥800 mL,duration of drainage time≥7 d,albumin＜35 g/L and white blood cell count＜4×109/L were the independent influencing factors of incision infection after modified radical mastectomy(P＜0.05).The peripheral blood levels of PCT,CRP,TNF-α and IL-6 in both groups increased compared with those before surgery,and those in the infected group were higher than those in the non-infected group(P＜0.05).Conclusion:staphylococcus aureus and escherichia coli were the main pathogens after modified radical breast mastectomy.Preoperative neoadjuvant chemotherapy,blood loss≥300 mL,postoperative drainage volume≥800 mL,drainage time≥7 d,albumin＜35 g/L and white blood cell count＜4×109/L were the independent influencing factors.The levels of serum PCT,CRP,TNF-α and IL-6 could be used as effective indicators to predict postoperative incision infection.

Background and purpose:In recent years,deep inspiration breath hold(DIBH)based on surface-guided radiation therapy(SGRT)has emerged as one of the most promising techniques in breast cancer radiotherapy.Conventionally,cone-beam CT(CBCT)is used before treatment to verify and correct patient positioning deviations.However,patient position may change during treatment,and pre-fraction CBCT cannot fully reflect real-time positional deviations.Therefore,this study aimed to introduce intra-fraction CBCT into left-sided breast DIBH radiotherapy to monitor and correct real-time deviations,verify whether patients achieve the desired position during treatment,and evaluate the clinical value of intra-fraction CBCT in left-breast radiotherapy.Methods:Clinical data from postoperative left-sided breast cancer patients treated at Fudan University Shanghai Cancer Center between June 2023 and January 2024 were collected.Patients with satisfactory cardiopulmonary function and stable DIBH compliance were included.Pre-fraction CBCT scans were performed before treatment,and data were recorded.During treatment,the gantry was rotated to-180° to trigger kV-level intra-fraction CBCT scanning.After gantry repositioning to the starting angle of the tangential field,MV beam delivery commenced.Intra-fraction CBCT scans were acquired for positional registration,and deviations were compared with pre-fraction CBCT results.Results:A total of 30 eligible patients were included,with 150 pairs of pre-fraction and intra-fraction CBCT images analyzed per patient.The mean registration deviations for intra-fraction CBCT were 26%,52%,and 51%lower than pre-fraction CBCT in the X,Y,and Z axes,respectively(P＜0.05),demonstrating significantly reduced real-time deviations.The probability of intra-fraction deviations being＜6 mm was 100.0%,100.0%,and 99.3%for the X,Y,and Z axes,respectively.Correlation analysis revealed a weak correlation between intra-fraction and pre-fraction deviations in the X-axis(P＜0.05),while no significant correlation was observed for the Y and Z axes(P＞0.05).Conclusion:Intra-fraction CBCT effectively monitors and corrects real-time positional deviations in left-sided breast DIBH radiotherapy,serving as a valuable supplement to conventional pre-fraction CBCT.It minimally impacts treatment efficiency while significantly improving positional accuracy,offering clinical and practical benefits for left-breast cancer radiotherapy.

Virus-like particles(VLPs)are hollow nanoparticles composed of one or several virus structural proteins,which have a morphological structure similar to natural viruses but do not contain any genetic material.Due to the excellent innate immunogenicity and safety of VLPs,they are often used in the development of tumor vaccines.In addition,compared with traditional drug delivery vectors,VLPs have better biocompatibility and strong targeting ability,making them highly valued in the delivery of anti-tumor drugs.In recent years,the efficient delivery of gene editing tools using VLPs has provided new possibilities for tumor treatment.VLPs can inhibit tumor growth and spread through various mechanisms,such as activating immune responses to suppress tumor growth,stimulating the body's immune system,promoting the expression of tumor associated antigens,and enhancing the body's ability to recognize and clear tumor cells.These studies not only broaden the application scope of VLPs in the field of anti-tumor therapy,but also provide a broader prospect for future research and application.This article reviewed the research progress of VLPs derived from different viruses in preventive or therapeutic vaccines and drug delivery carriers,and explored new development strategies.

Background and purpose:Next generation sequencing-identified genetic alterations of diffuse large B cell lymphoma(DLBCL)and baseline SUVmax detected by 18F-FDG PET/CT were correlated with patients'prognosis.However,their relationship and the associations with R-CHOP response of DLBCL are still unclear.This study aimed to analyze the association bewteen genetic alterations and 18F-FDG PET/CT SUVmax and their correlations with clinicopathological characteristics and R-CHOP response of DLBCL.Methods:A total of 225 cases of primary DLBCL detected by next generation sequencing using 481 lymphoma gene panel and examined by 18F-FDG PET/CT before treatment between 2022 and 2023 were collected.This study was approved by the Ethics Committee of Fudan University Shanghai Cancer Center(Ethical No.:050432-4-2307E)and acquired the informed consent of the patients.The translocations of BCL2,BCL6 and MYC were identified by fluorescence in situ hybridization.The clinicopathological characteristics and the PET/CT scan after R-CHOP chemotherapy were collected.Results:Finally,191 patients were enrolled in this study.The frequency of MYD88 mutation,TP53 mutation,copy number variations of CDKN2A/2B,CD79B mutation in the 191 DLBCL patients were 24.6%,27.2%,32.5%and 16.8%,respectively.The range of baseline SUVmax was 5.10-63.10(24.44±10.70,median 22.80).The baseline SUVmax of MYD88L265P DLBCL was significantly higher than that of MYD88 wild type(P=0.039).There were no significant associations of SUVmax with other gene alterations including TP53 mutation,CDKN2A/B loss,CD79B mutation,KMT2D mutation,TNFAIP3 mutation,B2M mutation,EZH2 mutation,BTG1/2 mutation,CREBBP mutation,gene translocations of MYC,BCL2 and BCL6.The higher SUVmax before treatment was correlated with higher serum lactate dehydrogenase(LDH)level(P=0.012)and non-germinal center B-cell-like(non-GCB)DLBCL(P=0.040).However,there was no significant association of SUVmax with R-CHOP response(P=0.714).TP53 mutation was significantly associated with the poor response of R-CHOP(P=0.001)and was an independent predictor of non-complete metabolic response(non-CMR).TP53 mutation combined with Ann Arbor stage,International Prognostic Index(IPI)score and serum LDH level could better predict R-CHOP response than each factor alone.Conclusion:MYD88L265P DLBCL had higher baseline 18F-FDG PET/CT SUVmax.The baseline SUVmax was not associated with R-CHOP response.However,TP53 mutation was significantly correlated with poor response of R-CHOP in DLBCL patients.TP53 mutation combined with clinicopathological characteristics could better predict R-CHOP response.The associations of gene alterations and SUVmax with prognosis of DLBCL patients needed to be explored in the future.

Background and purpose:Gastric cancer,as one of the most common malignant tumors,requires early diagnosis and treatment to improve patient prognosis.This study,based on serum quantitative proteomics research of early-stage gastric cancer patients and non-gastric cancer patients,aims to identify potential diagnostic biomarkers for early gastric cancer.Methods:Serum samples from primary gastric cancer patients and healthy control individuals were collected from Lanzhou University Second Hospital between June and December 2023,following inclusion and exclusion criteria.A protein spectral library was established using Data-Dependent Acquisition(DDA)mode,and each sample was analyzed using Data-Independent Acquisition(DIA)mode.The STRING database was used to analyze protein-protein interactions of upregulated proteins in gastric cancer serum.Kyoto Encyclopedia of Genes and Genomes(KEGG)and Gene Ontology(GO)were used to analyze the pathways and functional annotations of the corresponding genes.Gene expression levels in gastric cancer and non-gastric cancer tissues were analyzed using GEPIA 2,and overall survival of each gene in gastric cancer was analyzed using Kaplan-Meier Plotter.Differential gene expression in clinical gastric cancer and adjacent tissues was validated by quantitative reverse transcription polymerase chain reaction(qRT-PCR)This study was approved by the Ethics Committee of Lanzhou University Second Hospital(Ethical No.:2023A-459)and was exempt from the informed consent.Results:Finally,serum samples from 30 primary gastric cancer patients,29 healthy control individuals,along with the para-cancerous tissues from 8 patients were collected.A total of 666 intersecting proteins were identified through serum quantitative proteomics.Among them,16 proteins showed upregulated expression and 22 proteins showed downregulated expression in the gastric cancer group(P＜0.05,|FC|≥1.5).STRING database analysis showed that 10 upregulated proteins were involved in interaction networks.KEGG and GO analysis indicated that these genes were closely related to the biological processes of cancer occurrence and development.GEPIA 2 and Kaplan-Meier Plotter analysis showed that 6 genes,B2M,TAGLN2,CTSD,HSP90AB1,SH3BGRL3,and CFL1,which were highly expressed in the gastric cancer group(P＜0.05)and associated with poor prognosis.Clinical verification by qRT-PCR confirmed that TAGLN2,CTSD,SH3BGRL3,CFL1 and HSP90AB1 were highly expressed in gastric cancer tissues(P＜0.05).Conclusion:TAGLN2,CTSD,SH3BGRL3,CFL1,and HSP90AB1 have the potential to serve as clinical early gastric cancer diagnostic serum biomarkers,which may facilitate early diagnosis and treatment of gastric cancer.

Chemotherapy is a critical treatment modality for cancer,playing an essential role in oncology.However,chemotherapy-related diarrhea(CRD)remains a troubling adverse effect,often leading to reduced chemotherapy doses,treatment delays or discontinuation,and modifications to therapeutic plans.In severe cases,CRD can be life-threatening.5-fluorouracil and irinotecan are the most common chemotherapy drugs that cause CRD.With the increase in the use of triplet combination chemotherapy regimens,diarrhea-related deaths have increased,which may be related to neutropenic enterocolitis.Loperamide is the main drug for the treatment of CRD.In clinical practice,management of diarrhea that is not responsive to loperamide is of utmost concern.Therefore,based on evidence-based medicine and clinical practice experience,the expert panel carried out a comprehensive assessment and discussion on the definition,pathogenesis,classification,evaluation,diagnosis,intervention,and prevention of CRD.Eventually,the Chinese Expert Consensus on Whole-process Management of Chemotherapy-Related Diarrhea(2025 Edition)was formulated to further standardize the whole-process management of chemotherapy-related diarrhea.The consensus has been registered on Practice guideline REgistration for transPAREncy(PREPARE)with the registration number PREPARE-2024CN1246.

In January 2025,American Cancer Society released the latest cancer statistics,projecting approximately 2 041 910 new cancer cases and 618 120 cancer-related deaths in the United States(U.S.).The cancer mortality rate in the U.S.continues to decline,with a reversal in gender disparities and an increasing cancer burden among middle-aged and young populations.Significant differences in incidence and mortality rates are attributed to variations in population characteristics,intervention screening measures,healthcare accessibility,and policy factors across different regions and populations within the U.S.Compared with the U.S.,the cancer spectrum in China is different,and the incidence rates of lung cancer and breast cancer are rapidly rising among young women,with an average annual growth rate exceeding 3%.Infection-related cancer incidence rates are relatively high,with the incidence of gastric cancer,liver cancer and cervix cancer in China being 25.4/105,26.0/105 and 21.8/105 in 2022 respectively,surpassing U.S.incidence levels.Alarmingly,the cumulative HPV vaccination coverage among eligible Chinese women during 2018-2020 was merely 2.24%,reflecting dual barriers of low screening compliance and inadequate prevention infrastructure.There is a need to further enhance primary cancer prevention and comprehensive risk factor control,prioritize cancer prevention strategies for young and female populations,formulate population-tailored prioritized prevention frameworks and strengthen multi-stakeholder financing mechanisms for personalized screening programs,with the aim of achieving the"Healthy China 2030"cancer prevention and control goals and contributing China's approach to global cancer governance.

Isolated axillary recurrence(AR)after breast cancer surgery is one of the critical factors influencing patients'prognosis.With advancements in diagnostic and therapeutic techniques,the clinical understanding of AR has progressively deepened.However,due to the low incidence of AR,systematic studies on its clinical features remain limited.High-quality clinical trials,such as ACOSOG Z0011 and AMAROS,have demonstrated that in patients with varying statuses of sentinel lymph node,axillary lymph node dissection(ALND)and sentinel lymph node dissection(SLND)provide comparable control of AR.In recent years,the trend towards de-escalation axillary surgery has advanced the development of less invasive techniques such as targeted axillary lymph node dissection.The SOUND trial further confirmed the safety and feasibility of omitting axillary surgery in patients with tumors≤2 cm.In addition,a series of clinical studies have identified a variety of potential high-risk factors,including patient age,number of positive lymph nodes,high Ki-67 proliferation,extranodal extension,and axillary soft tissue infiltration.However,there is no broad consensus regarding the association of these factors with AR.This review comprehensively summarized the clinical characteristics,risk factors and personalized management strategies of AR,with an emphasis on the impact of different axillary surgical approaches,radiotherapy and systemic therapy on the AR risk.In addition,more high-quality clinical studies are urgently needed to further clarify prognostic factors and optimize individualized treatment strategies,so as to provide more precise management for patients.

Background and purpose:Members of the serine protease inhibitor(SERPIN)family can influence tumorigenesis,progression,and prognosis by modulating processes such as apoptosis,invasion,metastasis,and angiogenesis in tumor cells.However,their role in pancreatic cancer remains unclear.This study aimed to investigate the impact of high expression of serine protease inhibitor A3(SERPINA3)on the proliferation,apoptosis,migration,and chemoresistance of pancreatic cancer cells and its mechanism.Methods:This study analyzed the SERPINA3 expression levels in the normal pancreatic ductal epithelial cell line hTERT-HPNE and pancreatic cancer cell lines SW1990,Capan-1,PANC-1,and ASPC-1 by real-time reverse transcription quantitative polymerase chain reaction(qRT-PCR).We established gemcitabine-resistant pancreatic cancer cell lines PANC-1/R and ASPC-1/R,and used qRT-PCR assay and cell counting kit-8(CCK-8)to determine the SERPINA3 expression levels in the constructed resistant cell lines and their parental sensitive cell lines,as well as the differences in their chemosensitivity to gemcitabine.We constructed the SERPINA3-knockdown cell line si-SERPINA with siRNA,and the negative control group si-SERPINA#NC with siRNA negative control.We used MDA assay,CCK-8 assay,EdU cell proliferation assay,transwell migration assay,matrigel invasion assay,scratch assay,and apoptotic assay to respectively detect the lipid oxidation levels,proliferation,migration,invasion,wound-healing ability,and the influence on apoptosis of the gemcitabine-resistant pancreatic cancer cells in the si-SERPINA group and the si-SERPINA#NC group.Results:Compared with normal pancreatic ductal epithelial cells hTERT-HPNE,the expression level of SERPINA3 in various pancreatic cancer cell lines was significantly increased(P＜0.05).mRNA and protein expression levels of SERPINA3 in PANC-1/R and ASPC-1/R were significantly increased compared with those in parent cells(P＜0.001).When SERPINA3 was knocked down in PANC-1/R and ASPC-1/R cells,the survival rate of the cells under different concentrations of gemcitabine chemotherapy decreased,and MDA detected that the lipid oxidation level was increased(P＜0.001).In addition,the proliferation rate of PANC-1/R and ASPC-1/R cell lines with SERPINA3 knockout,the number of migrating/invading cells and the healing rate of scratch test were significantly decreased(P＜0.01),and flow cytometry demonstrated that the number of apoptotic cells was increased(P＜0.05).These results suggest that SERPINA3 knockdown can inhibit the proliferation,migration,invasion and wound healing ability of gemcitabine-resistant pancreatic cancer cells,and promote the apoptosis of these resistant cells.Conclusion:SERPINA3 overexpression was found in various pancreatic cancer cells.SERPINA3 overexpression promoted malignant progression and chemotherapy resistance of pancreatic cancer,and interference with SERPINA3 expression promoted ferroptosis and enhanced chemotherapy sensitivity of gemcitabine-resistant pancreatic cancer cells.

Background and purpose:The treatment of recurrent,metastatic,and treatment-na?ve advanced cervical cancer remains challenging.Immunotherapy in combination with chemotherapy and targeted therapy has shown preliminary clinical benefits,however,current evidence remains limited.This study aimed to evaluate the impact of camrelizumab combined with chemotherapy and targeted therapy on the prognosis of patients with recurrent,metastatic,and treatment-na?ve advanced cervical cancer.Methods:In this study,we conducted a retrospective analysis of the clinical data from 130 patients with recurrent,metastatic,and treatment-na?ve advanced cervical cancer admitted to Minhang Branch of Fudan University Shanghai Cancer Center from 2019 to 2025.The patients were categorized into the observation group(n=70),which included those who received camrelizumab with or without chemotherapy and targeted therapy,and the control group(n=60),including those who received chemotherapy and targeted therapy.Survival analysis was performed using the log-rank test,and univariate and multivariate Cox regression analyses were conducted to explore prognostic factors.This study was approved by the Ethics Committee of the Minhang Branch of Fudan University Shanghai Cancer Center[Approval number:(2024)Review No.(015)]and all informed consents were exempted.Results:The objective response rate(ORR)in the observation group was 72.9%,and the disease control rate(DCR)was 80.0%,which were significantly higher than those in the control group with an ORR of 20.0%(χ2=36.1,P＜0.001)and a DCR of 40.0%(χ2=21.8,P＜0.001).The median progression-free survival(PFS)in the observation group was not reached,significantly longer than that in the control group of 7.0 months(P＜0.001).Multivariate Cox regression analysis identified camrelizumab treatment as an independent protective factor for PFS(P＜0.001).Age,site of recurrence/metastasis,initial treatment approach,and histopathological type were not significantly associated with PFS.In the observation group,adverse events of grade 3 or higher were reported in 29 patients(41.4%),which primarily included vasculitis,hypothyroidism,hypersensitivity reactions,and diarrhea.Conclusion:The use of camrelizumab significantly improved treatment outcomes and prognosis for patients with recurrent,metastatic,and treatment-na?ve advanced cervical cancer,with significantly improved progression-free survival.Although a certain proportion of patients experienced adverse events of grade 3 or higher,the overall safety profile was acceptable.In clinical practice,immunotherapy offers a more effective treatment option for patients.