[Purpose]To analyze and evaluate the application effect of quantitative fecal immuno-chemical test(FIT)in the opportunistic screening of colorectal cancer(CRC)in health examination population.[Methods]10 025 healthy individuals who completed quantitative FIT at the Health Management Cancer of Sichuan Cancer Hospital from January 1,2021 to December 31,2023 were included.Participants with positive FIT results were recommended for diagnostic colonoscopy.Quantitative FIT positivity rate,colonoscopy screening compliance rate,and colorectal lesion de-tection rate in the queue population were analyzed,the detection rate of colorectal lesions and colonoscopy resource load between quantitative FIT positive and negative colonoscopy screening groups at all levels were compared and the diagnostic efficacy of quantitative FIT for non progres-sive lesions and progressive lesions were explored.[Results]The positive rate of quantitative FIT was 6.24％(95％CI:5.77％～6.71％).The compliance rate of colonoscopy screening was 20.93％(95％CI:17.74％～24.12％).Among 284 colonoscopy patients,7 cases were detected with CRC,21 cases with advanced adenomas,52 cases with non advanced adenomas,40 cases with non adenomatous polyps,51 cases with other benign lesions,and 113 cases without abnormalities.The detection rates of non advanced adenomas,advanced adenomas,colorectal cancer,non pro-gressive lesions and progressive lesions in the quantitative FIT positive group were significantly higher than those in the quantitative FIT negative group.The detection rates of those without obvi-ous abnormalities were significantly lower than those in the quantitative FIT negative group,and the differences were statistically significant(all P＜0.05).The resource burden of colonoscopy in the quantitative FIT positive and negative groups was 5.46(95％CI:1.56～9.34)and 38.25(95％CI:30.55～45.95),respectively.The level of FIT measurement gradually increases with the severity of the lesion,and the difference between groups is statistically significant(H=48.308,P＜0.001).Quan-titative FIT has high sensitivity and negative predictive value for non progressive lesions and pro-gressive lesions,with values of 71.15％,85.71％and 90.20％,97.39％,respectively.The AUC values for quantitative FIT screening of non progressive lesions and progressive lesions were 0.653(95％CI:0.572～0.734,P=0.001)and 0.720(95％CI:0.631～0.808,P＜0.001),respectively.[Conclusion]Quantitative FIT,as a suitable technique for CRC opportunistic screening in health check-up population,has good diagnostic efficacy for non progressive lesions and progressive le-sions.Performing colonoscopy on FIT positive individuals can improve lesion detection rates while reducing colonoscopy resource consumption,aligning with China's healthcare resource landscape.

Lymphomas represent a group of highly heterogeneous malignant tumors.The tumor microenvironment(TME)surrounding these tumors plays a crucial role in disease progression and the efficacy of therapeutic interventions.Traditional two-dimensional cell cul-ture models fail to accurately recapitulate the inherent complexity of three-dimensional(3D)in vivo architecture.Organoid technology provides a novel tool for lymphoma research,utilizing 3D culture systems to reconstruct tumor tissue organization and functionality.Despite the potential of this technology,the development of lymphoma organoid models remains a significant challenge.Developing lymphoma or-ganoid models faces numerous hurdles,including replicating the unique biological characteristics of lymphoma and itscomplexmicroenvir-onment.This study provides a systematic summary of challenges associated with lymphoma organoid construction and describes recent ad-vances in relevant methodologies.Moreover,the study further reviews recent advances in co-culture techniques combining lymphoma or-ganoids and immune cells,including protocols for culturing patient-derived primary central nervous system lymphoma organoids and patient-derived lymphoma organoids.These advances have significantly facilitated the clinical translation of lymphoma research,transitioning it from fundamental mechanistic studies toward personalized and precision therapeutic approaches.

Objective:To investigate the incidence of port-site metastasis (PSM) after laparoscopic surgery in patients with epithelial ovarian cancer and prognostic factors influencing outcomes in those with abdominal wall PSM.Methods:Clinicopathological and follow-up data of 22 ovarian epithelial cancer patients diagnosed with abdominal wall PSM after laparoscopic surgery, who were treated in the Sichuan Cancer Hospital between May 2014 and July 2023, were retrospectively collected. A retrospective analysis of PSM characteristics and prognostic factors influencing outcomes, was conducted in these patients.Results:(1) Between May 2014 and July 2023, a total of 369 ovarian cancer patients with a history of laparoscopic surgery performed at other hospitals were admitted. Among them, 24 cases (6.5%, 24/369) were diagnosed with tumor lesions at the abdominal wall port sites via postoperative pathological examination, with a median interval time of 25.5 days (interquartile range: 19.5, 32.0 days) after laparoscopic surgery. Of these, 22 cases with complete clinicopathological and follow-up data were included in this study. (2) The age of the 22 PSM patients was (53.0±8.6) years, and the median follow-up time was 37.6 months (24.7, 63.4 months). Surgical-pathological staging revealed stage Ⅰ-Ⅱ disease in 4 cases and stage Ⅲ-Ⅳ disease in 18 cases. Histopathological differentiation included 5 cases of well-to-moderately differentiated tumors and 17 cases of poorly differentiated tumors. Pathological subtypes comprised 11 cases of high-grade serous adenocarcinoma, 5 cases of low-grade serous adenocarcinoma, and 6 cases of clear cell carcinoma or cystadenocarcinoma. Lymph node status was as follows: negative for lymph node metastasis ( n=16), positive ( n=5), and no lymphadenectomy performed ( n=1). Postoperative residual disease was categorized as no macroscopic residual disease ( n=13), residual disease ≤1 cm ( n=7), and residual disease >1 cm ( n=2). (3) Following secondary cytoreductive surgery combined with postoperative adjuvant therapy, the median progression-free survival and overall survival (OS) time of the patients were 8.8 months (4.6, 14.3 months) and 27.7 months (15.5, 38.4 months), respectively. Univariate Cox regression analysis demonstrated that surgical-pathological stage, histopathological differentiation grade, and lymph node metastasis status were significantly associated with OS time in patients with abdominal wall PSM (all P<0.05). In contrast, age, Eastern Cooperative Oncology Group performance status score, histopathological subtype, preoperative serum cancer antigen 125 level, presence of residual lesions after surgery and poly adenosine diphosphate ribose polymerase inhibitor usage showed no significant correlation with OS time (all P>0.05). Multivariate Cox regression analysis identified surgical-pathological stage ( HR=4.579，95% CI：1.111-18.866； P=0.035) and histopathological differentiation grade ( HR=5.307，95% CI：1.042-27.031； P=0.045) as independent risk factors for OS time in PSM patients. Conclusion:Abdominal wall PSM following laparoscopic surgery for epithelial ovarian cancer maybe adversely affect patient prognosis, particularly in cases with advanced stage and poorly differentiated tumors, which warrants significant clinical attention.

Objective:To explore the feasibility of automatic target volume tracing in the Elekta Unity magnetic resonance imaging (MRI)-guided radiotherapy system and to further enhance the real-time target volume tracing performance of MRI-guided radiotherapy by introducing the deep learning technology based on a large Transformer model.Methods:A total of 4 661 frames of cine MRI binary images from 75 patients with malignant tumors in the chest/abdomen who were treated with MRI-guided radiotherapy were retrospectively collected as a training set. Another 500 frames of cine MRI binary images from 10 patients were collected as an independent test set. A module for medical image format conversion was developed to convert binary images into medical meta-images. The outer contours of tumor target volumes in the cine MRI images of the test set were manually delineated as actual control labels. With the first frame of the cine MRI images of each patient as the reference image and the other frames as motion images, a Transformer-based deep learning model was constructed to describe the deformable vector field (DVF) of motion images relative to the reference image. The Dice similarity coefficient (DSC), the 95% Hausdorff distance (HD 95), the negative Jacobian determinant (NegJ), and the average processing time per frame of cine MRI images were calculated. These values were compared to those of the conventional B-Spline scheme to quantitatively assess the target volume tracing accuracy, DVF physical plausibility, and execution efficiency of the Transformer-based deep learning model. Results:The Transformer-based deep learning model constructed in this study delivered superior target volume tracing performance, with improved DSC [(0.84 ± 0.05) vs. (0.74 ± 0.16), t = 11.44, P < 0.05] and HD 95 [(9.25 ± 2.98) vs. (14.70 ± 8.55) mm, t = -11.83, P < 0.05]. Furthermore, this model reduced the average image processing time from 1.95 s to 30.99 ms, enhancing the efficiency by two orders of magnitude. Besides, this model yielded NegJ similar to that of the B-Spline scheme. This suggests that the DVF extracted using this model had comparable physical plausibility with that obtained using the B-Spline scheme. Conclusions:The Transformer-based deep learning model for automatic target volume tracing fills the functional gap of the Elekta Unity MRI-guided radiotherapy system, facilitating relatively accurate, efficient automatic tracing of moving tumor targets in the chest and abdomen.

Objective:To compare the dose-response effects of single-fraction ultra-high dose rate (FLASH) and conventional dose rate (CONV) whole abdominal irradiation (WAI) with X-rays on acute radiation-induced intestinal injury in mice, in order to identify optimal dose parameters and potential mechanisms.Methods:A total of 186 male C57BL/6J mice were randomly assigned to a non-irradiation group ( n=6), FLASH irradiation groups ( n=90), and CONV irradiation groups ( n=90). Acute radiation-induced intestinal injury models were established using single-fraction WAI with 11, 12, 13, 14, and 15 Gy X-rays (200 Gy/s for FLASH and 4 Gy/min for CONV). Changes in body weight, stool characteristics, and disease activity index (DAI) scores were assessed at 9 d post-irradiation. At 7 d post-irradiation at 11, 12, and 13 Gy, the intestines were collected for macroscopic examination and length measurement. The small intestine was selected for HE staining and quantitative analysis of intestinal crypt number and mucosal epithelial thickness. The survival of mice was assessed at 15 d post-WAI across all dose groups. Results:After single-fraction WAI at 11, 12, and 13 Gy, the body weight was higher in the FLASH group than that in the CONV group ( t=10.17, 12.65, 10.16, P<0.05). The DAI scores for the FLASH group were 1.00±1.10, 3.17±0.75, and 2.83±1.17, respectively, which were lower than those of the CONV group (4.33±0.52, 7.00±0.00, 8.60±0.55; t=8.70, 11.71, 14.99, P<0.05). However, after WAI at 14 Gy and 15 Gy, there were no significant differences in body weight and DAI between the FLASH group and the CONV group ( P>0.05). At 7 d after single-fraction WAI at 11, 12, and 13 Gy, mice in the FLASH group exhibited less intestinal congestion, edema, and shortening compared with the CONV group. The difference between the FLASH and CONV groups were statistically significant in small intestine length at 11 and 13 Gy ( t=4.42, 3.78, P<0.05), and in colorectal length at 11 and 12 Gy ( t=3.97, 3.12, P<0.05). Small intestine HE staining revealed superior preservation of intestinal architecture in the FLASH group compared with the CONV group, characterized by longer villi, increased crypt numbers, thicker mucosal epithelium, and enhanced structural integrity. The differences in crypt number and mucosal epithelial thickness were statistically significant ( tcrypt=13.10, 23.80, 11.90; tmucosal=5.75, 2.64, 7.74; P<0.05). At 15 d post-irradiation, the survival rate in the 15 Gy FLASH group was higher than that in the CONV group (50% vs. 10%, χ2=5.39, P<0.05), with a median survival extension of 6 d ( HR=0.340, 95% CI: 0.115 4-0.999 9). No significant survival differences were observed between the FLASH group and the CONV group at 11, 12, 13, and 14 Gy ( P>0.05). Conclusions:FLASH irradiation significantly alleviated acute radiation-induced intestinal injury from medium single-fraction WAI with 11, 12, and 13 Gy X-rays compared with CONV irradiation, and showed potential to improve mouse survival after single-fraction WAI at 15 Gy. This effect is likely associated with the preservation of intestinal crypts and exhibits a dose-dependent relationship.

Objective To explore the effectiveness and safety of hypofractionated radiotherapy(HFRT)combined with transcatheter arterial chemoembolization(TACE)for metachronous hepatic oligometastasis from nasopharyngeal carcinoma(NPC).Methods The clinical data of patients with metachronous hepatic oligometastasis from NPC,who received HFRT combined with TACE treatment at the Sichuan Provincial Cancer Hospital of China from January 2012 to October 2022,were retrospectively analyzed.The 3-year and 5-year overall survival(OS),progression-free survival(PFS),local recurrence-free survival(LRFS),no extrahepatic distant metastasis survival(EMFS),and treatment-related adverse reactions were analyzed.Results A total of 55 patients were enrolled in this study,including 36 males and 19 females,the median age at the time of occurring metachronous hepatic oligometastasis was 44(27-75)years.The 3-year and 5-year OS,PFS,LRFS,EMFS were 67.8％and 40.0％,55.8％and 30.0％,72.7％and 56.5％,63.6％and 56.5％,respectively.The subgroup analysis indicated that the treatment course of TACE ≥3 cycles could significantly improve the PFS of patients with oligometastasis.HFRT combined with TACE treatment was well tolerated by all patients,and the incidence of Grade Ⅲ-Ⅳadverse reactions was quite low.Conclusion For the treatment of metachronous hepatic oligometastasis from NPC,HFRT combined with TACE is clinically effective,besides,the patients can well tolerate the therapeutic scheme.

As the cornerstone of modern medical diagnosis,pathology is facing multiple challenges such as workforce shortages,strong diagnostic subjectivity,and inefficient workflows.With advantages in image recognition,pattern analysis,and big data processing,artificial intelligence(AI)is increasingly being integrated into the field of pathological diagnosis,driving its transition toward digitization and intelligence.This article systematically reviews the development of AI in pathology,from early supervised learning validation to weakly supervised learning overcoming annotation bottlenecks,and the recent rise of self-supervised and multimodal foundation models.It demonstrates the broad applications of AI in improving diagnostic consistency,optimizing workflows,and predicting molecular features and prognoses.AI not only enhances the objectivity and efficiency of pathological diagnosis but also promotes the development of emerging interdisciplinary fields such as computational pathomics,providing strong support for precision medicine.Although challenges such as data standardization and regulatory approval remain in clinical implementation,the deep integration of AI and pathology is ushering in a new era of human-machine collaboration and intelligent diagnostics.

Chimeric antigen receptor T-cell(CAR-T)therapy,as a revolutionary immunotherapy,has achieved significant clinical efficacy in the treatment of hematologic malignancies in recent years.However,its clinical application remains limited by associated toxicities.Bridging therapy,as a supplementary antitumor treatment administered between leukapheresis and CAR-T cell infusion,reduces tumor burden and modulates the immune microenvironment through chemotherapy,radio-therapy,targeted therapy,and immunotherapy.It not only delays disease progression but also sig-nificantly influences the toxicities associated with subsequent CAR-T therapy.This paper reviews the main types of toxicities and management strategies of CAR-T therapy,and analyzes the role of bridging therapy in managing these toxicities,conducting an in-depth analysis of the potential mechanisms by which different bridging therapy modalities influence these toxicities,to provide scientific basis and practical guidance for the clinical application of CAR-T therapy.

As a key link in data governance,data asset auditing is of great significance in improving data quality,ensuring data asset security,optimizing data asset management,and meeting compliance requirements.Based on the full lifecycle perspective of data assets in public hospitals,combined with the characteristics and functional responsibilities of internal auditing in public hospitals,a mechanism for implementing data asset auditing in public hospitals is constructed,including locking the data asset auditing mode with a supervision and operation mechanism,conducting targeted analysis of key areas of data asset auditing with a review and evaluation mechanism,promoting standardized management of hospital data assets with a feedback improvement mechanism,and providing guarantees for the high-quality and effective development of data asset auditing with a quality improvement mechanism.Aiming to achieve closed-loop management of the entire process of data asset auditing in public hospitals,using auditing as a driving force to fully unleash the value of hospital data assets and assist in the high-quality development of public hospitals.

Proton arc therapy (PAT), as an emerging radiation therapy technique, has attracted increasing widespread attention in the field of cancer radiotherapy in recent years. In this review, technological developments, clinical application potential, biological effects, dosimetric optimization, and current challenges of PAT were comprehensively summarized. A systematic analysis of recent studies indicates that PAT offers significant advantages in improving target coverage and sparing normal tissues, particularly in mitigating organ motion-induced uncertainties. However, PAT remains in the clinical validation stage and still faces challenges related to technical optimization and cost control. Further clinical studies are required to confirm its long-term efficacy and safety.