Cervical cancer is the most common reproductive system malignancy in women.Its primary cause is persistent infection with high-risk human papillomavirus.Traditional treatment methods include surgery,radiotherapy,and chemotherapy,but the prognosis for ad-vanced cervical cancer remains dismal.In recent years,therapeutic vaccines,immune checkpoint inhibitors,adoptive T cell therapy,and oth-er immunotherapies have been widely used in cervical cancer,notably improving patient survival.This article reviews clinical trials and re-cent advances in immunotherapy for in locally advanced cervical cancer(LACC).

Pancreatic cancer is a highly malignant tumor and remains one of the most lethal types of cancer at this stage. Patients with pancreatic cancer have poor 5-year survival rates because of the relatively insidious clinical symptoms of the disease and its more rapid ability to invade surrounding tissues. Trends in pancreatic cancer incidence and mortality rates vary widely around the world. To date, certain risk factors, such as genetic factors, age factors, diabetes, obesity, chronic pancreatitis, and immune escape, have been identified as contributing to the development of pancreatic cancer. However, at this stage, there are no clear recommendations for pancreatic cancer screening, and cancer antigen 19-9 can only be used to monitor treatment response and as an indicator of disease recurrence, so primary prevention of pancreatic cancer is of utmost importance. In this article, the current status of the pancreatic cancer epidemic and the progress of research on etiological mechanisms were reviewed.

Effective screening and early diagnosis can significantly improve the prognosis of lung cancer and reduce lung cancer mortality. At present, low-dose computed tomography (LDCT) is the most important screening method for lung cancer. At the same time, the benign and malignant evaluation of pulmonary nodules also determines whether patients can detect cancer early and provides the basis for the cancer prognosis. The related autoantibodies of lung cancer have also been gradually used in the screening and early diagnosis of clinical lung cancer. However, all techniques and methods have their limitations, and the optimal combination may be the best choice. In this review, the research status and challenges of screening and early diagnosis of lung cancer were reviewed.

Objective To compare the difference in diagnostic value between conventional ultrasound and contrast-enhanced ultrasound (CEUS) for focal liver lesions and observe the application value of CEUS in the diagnosis and differential diagnosis of focal liver lesions. Methods Eighty-three patients who carried out conventional examination were diagnosed as focal liver lesions admitted to the Department of Ultrasound in Tianjin Medical University Cancer Hospital from May 2012 to July 2016, and totally 93 lesions were found. The types of lesions were determined by conventional ultrasonography, CEUS and pathology, and the effectiveness of conventional ultrasound and CEUS in the diagnosis of focal lesion types was compared, the time-intensity curve was used to record the beginning time of enhancement, peak time of enhancement, washout time and peak strength in different types of focal liver lesion, that may provide certain characteristics for differentiation of benign from malignant lesions, and the patterns of CEUS in different types of liver focal lesion were observed. Results Pathological examination confirmed the types of lesions:there were 57 malignant focal lesions in 93 lesions (including 34 hepatocellular carcinoma, 11 cholangiocarcinoma, 11 metastatic tumors and 1 lymphoma in liver), there were 36 benign lesions in 93 lesions [including 16 liver abscesses, 5 liver focal nodular hyperplasia (FNH), 5 hepatic adenomas, 4 hemangiomas, 3 uneven fatty liver, 2 hepatic cysts, and 1 hepatic perivascular cytoma]. By conventional ultrasound 51 focal liver lesions and by CEUS 80 focal liver lesions were correctly diagnosed. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CEUS in diagnosing focal liver lesions were significantly higher than those of conventional ultrasound: 91.23% vs. 68.42%, 77.78% vs. 33.33%, 86.67% vs. 61.90%, 84.85% vs. 40%, 86.02% vs. 54.84%, respectively, the differences being statistically significant (all P < 0.01). All of malignant lesions including the arrival time (seconds: 11.17±2.15 vs. 15.92±2.90), the enhancement peak time (seconds: 21.13±3.06 vs. 40.93±11.71), the washout time (seconds:37.16±6.84 vs. 73.51±11.80) were earlier than those of benign lesions, and peak strength of malignant lesion was higher than that of benign lesions (dB: -46.64±3.60 vs. -63.36±15.38), the difference being statistically significant (all P < 0.01). Under CEUS pattern, different liver focal lesions revealed different types of enhancement, but in part of the focal lesions the types of enhancement had manifestations crossed. Conclusions CEUS improves the diagnostic efficacy for focal liver lesions which has great value for differential diagnosis of benign from malignant liver lesions.

With the continuous update and improvement of minimally invasive techni-ques, laparoscopic and robotic surgeries have increased significantly for the surgical treatment of adenocarcinoma of esophagogastric junction (AEG). Due to the anatomical particularity and biolo-gical characteristics of Siewert type Ⅱ AEG, surgical approach, the range of resection, lymph node dissection and digestive tract reconstruction cannot be unified at present, which is also the contro-versy between gastrointestinal surgery and thoracic surgery. Laparoscopic minimally invasive techni-que may be more conducive to lower mediastinal lymph node dissection. Laparoscopic surgery of AEG after neoadjuvant chemotherapy is safe and feasible. Robotic surgery may be the direction of minimally invasive surgery in the future. The authors mainly investigate strategies of minimally invasive surgery for the surgical treatment of AEG, and look forward to more clinical trials on Siewert type Ⅱ AEG surgery to guide surgical treatment.

With the advent of perioperative immunotherapy for non-small cell lung cancer(NSCLC),the management of anesthesia in thoracic surgery has become challenging.Different choices for anesthesia modalities and drugs affect immune function,tumor growth,and metastasis.Cancer immunotherapy with immune checkpoint inhibitors activates antitumor immunity,affecting local and systemic immune response.Anesthesia and immunotherapy may cause unpredictable interactions.This review examines the impact of anesthetic modalities and pharmaceuticals along with immunotherapy on the immune status and prognosis of NSCLC,offering new insights for their perioperative management in patients with NSCLC.

Malignant tumor blood vessels,with phenotypes that are similar to high endothelial venules(HEVs)in secondary lymphoid or-gans(SLO),are known as tumor-associated high endothelial venules(TA-HEVs).The formation mechanism of TA-HEVs is similar to that of HEVs.Moreover,TA-HEVs play an important role in promoting the infiltration of lymphocytes into tumor tissues.With ongoing research,the positive effect of TA-HEVs in the context of radiotherapy,chemotherapy,immunotherapy,and antiangiogenic therapy is being elucidated.The clinical value is gradually becoming prominent,and the mechanisms and pathways involved with TA-HEVs are still under investigation.

The incidence of breast cancer currently ranks first among malignant tumors in women.Breast cancer exhibits high heterogeneity and can be classified into four molecular subtypes:luminal A,luminal B,human epidermal growth factor receptor 2(HER2)overexpression and triple-negative.However,previous molecular subtype classifications have limited treatment options for patients with HER2 low expression.In recent years,with the rapid development of antibody-drug conjugates(ADCs),new treatment options have emerged for breast cancer patients with HER2 low expression.This has also led to updates in the criteria for determining HER2 expression status in both domestic and international guidelines,based on immunohistochemistry(IHC)and in situ hybridization(ISH)testing,categorizing HER2 expression as HER2-positive(IHC 3+ or IHC 2+/ISH+),HER2 low expression(IHC 1+ or IHC 2+/ISH-),and HER2-negative(IHC 0).ADCs are immunotherapeutics composed of a linker that conjugates a monoclonal antibody with a cytotoxic payload.In the field of breast cancer,several large clinical trials have demonstrated clinical benefits of ADCs targeting HER2,such as trastuzumab emtansine(T-DM1),trastuzumab deruxtecan(T-DXd)and sacituzumab govitecan targeting trophoblast cell surface antigen 2(TROP2),in various molecular subtypes of breast cancer.With the phaseⅢ DESTINY-Breast03 trial and others,T-DXd has been found to have superior efficacy compared to T-DM1 in advanced HER2-positive breast cancer patients(approximately two times higher complete response rate,and four times longer median progression-free survival).T-DXd has now replaced T-DM1 as the recommended second-line therapy for HER2-positive breast cancer and as a second-line treatment option after local treatment for brain metastasis.The phase Ⅲ DESTINY-Breast04 trial confirmed that breast cancer patients with HER2 low expression can also benefit from T-DXd,further reshaping the treatment landscape for advanced breast cancer and supporting the need to redefine molecular subtypes of HER2-negative breast cancer.The phase Ⅲ ASCENT trial demonstrated that sacituzumab govitecan significantly improved survival and quality of life in triple-negative breast cancer(TNBC)patients,and the phase Ⅱ NeoSTAR study suggested its potential as neoadjuvant therapy in TNBC.Based on evidence,T-DM1,T-DXd and sacituzumab govitecan have been approved for marketing in both foreign and Chinese markets.Other ADC drugs,such as HER3-DXd,Dato-DXd and China-developed RC48,are also undergoing extensive clinical trials in the field of breast cancer and other tumors.Furthermore,there are several other ADCs targeting different molecular targets in active development.This article aimed to review the new advances related to ADCs therapy for breast cancer patients with different molecular subtypes and discuss the clinical application value of ADCs in breast cancer.

Sarcopenia is a common clinical syndrome in cancer patients and is becoming an independent poor prognostic factor. Studies have shown that an appropriate increase in protein, vitamin D, Omega-3, and other nutrient intake combined with exercise, while ensuring appropriate energy intake, can improve or even reverse sarcopenia. In this review, the research progress in the assessment and diagnosis, epidemiological features, clinical outcomes, and interventions for sarcopenia in patients with head and neck cancer was reviewed.

Objective To investigate the use and application trend of antibiotics in a cancer hospital in Tianjin,so as to provide reference for the rational clinical use of antibiotics.Methods The related data of antibiotics in the hospital from January 2018 to January 2021 were selected,and the utilization rate,defined daily doses(DDDs)of drugs,antibiotics use density(AUD),defined daily cost(DDC)and ranking ratio(B/A)of antibiotics were statistically analyzed.Results In 2018-2021,the annual use of antibiotics,utilization rate of antibiotics and AUD showed a downward trend.The mean annual utilization rate of antibiotics was 22.42％,and the mean annual AUD was 26.79 DDDs/(100 person·d).The top three antibacterial drugs in terms of annual consumption and DDDs were cephalosporins,carbapenems and penicillins.The main antibacterial drugs at all levels were unrestricted.There were 6 antibacterial drugs with DDC＞100.Voriconazole had the highest DDC.The B/A of ciprofloxacin sodium chloride,moxifloxacin tablets,Latoxefin sodium,moxifloxacin sodium chloride was close to or equal t0 1,indicating that the synchronization of these antibacterial drugs was good.Conclusion In 2018-2021,the selection and use of antibiotics in the cancer hospital in Tianjin was reasonable,and the clinical application indicators met the national standards.