Background/Aims: Liver transplantation (LT) following total hepatectomy is a life-saving treatment for hepatocellular carcinoma (HCC). The HCC recurrence after LT hinders the effectiveness of the procedure. The objective of this study is to develop a pre-operative risk stratification model based on a liquid biopsy. Methods: We conducted a comprehensive multi-omics study of 260 HCC patients from three centers, including clinical data, low-coverage whole-genome sequencing of cell-free DNA (cfDNA) from plasma, as well as whole-exome, single-nucleus RNA, and spatial transcriptomics from matched tumor and non-tumor tissues. Results: We identified cfDNA-derived copy number alteration (CNA) signatures associated with post-transplant recurrence. By integrating cfDNA-derived CNA profiles with single-cell transcriptomic data, we traced recurrence-associated cfDNA to a distinct subpopulation of malignant cells within the primary tumor. These cells were embedded in a pro-metastatic microenvironment of specialized endothelial subtypes and cancer-associated fibroblasts. Notably, most recurrence-associated lesions were detectable in cfDNA prior to liver transplantation (LT). Building on these insights, we developed the ZJU Criteria based on CNA fragments and tumor markers, a pre-LT risk prediction tool that integrates conventional clinical factors with cfDNA-derived CNA signatures, and validated it using internal and independent external cohorts. Conclusion Our findings suggest that post-transplant recurrence commonly originates from advanced subclones that emerge late during tumor evolution. The ZJU Criteria provides an accurate, non-invasive strategy that significantly improves pre-LT risk stratification and clinical decision-making for patients with HCC.

To retrospectively analyze the clinical data of 465 newly diagnosed patients with multiple myeloma (NDMM) admitted to the First Affiliated Hospital of Nanjing Medical University from December 2016 to December 2024, and compare the prognostic value of high-risk cytogenetic abnormalities (HRCAs) in NDMM patients under mSMART 3.0 and mSMART 4.0 risk stratification systems. The results showed that in both stratification systems, the prognosis of high-risk patients was worse than that of standard-risk patients. Moreover, a higher number of HRCAs was associated with a worse prognosis. The mSMART 4.0 system, which considers the coexistence of various cytogenetic abnormalities, provides a more precise definition of HRCA than mSMART 3.0. It demonstrates a superior ability to differentiate between different categories of cytogenetic risk.

To retrospectively analyze the clinical data of 465 newly diagnosed patients with multiple myeloma (NDMM) admitted to the First Affiliated Hospital of Nanjing Medical University from December 2016 to December 2024, and compare the prognostic value of high-risk cytogenetic abnormalities (HRCAs) in NDMM patients under mSMART 3.0 and mSMART 4.0 risk stratification systems. The results showed that in both stratification systems, the prognosis of high-risk patients was worse than that of standard-risk patients. Moreover, a higher number of HRCAs was associated with a worse prognosis. The mSMART 4.0 system, which considers the coexistence of various cytogenetic abnormalities, provides a more precise definition of HRCA than mSMART 3.0. It demonstrates a superior ability to differentiate between different categories of cytogenetic risk.

Objective To study the diagnostic value of MSCT in cystic lung cancer with ground glass opacity(GGO),and improve understanding of the disease as well as diagnostic accuracy.Methods 2 1 cases of pathologically confirmed cystic lung cancer with GGO were analyzed retrospectively,all patients were examined by MSCT.CT features of the GGO and the cysts,including bronchovascular convergence sign,speculation sign,pleural indentation sign,lobulation,thickness and uniformity of the cyst wall,septa and the location of the lesion were analyzed.Results The image findings of the 21 cases of the cystic lung cancer with GGO included:bronchovasular convergence sign in 6 cases(28.6%),speculation sign in 10 cases(47.7%),pleural indentation sign in 12 cases(57.1%),lobulation in 8 cases(38.1%),10 cases(47.7%)showed pure GGO.The cyst wall was(1.7±0.9)mm in thickness and the cyst was (13.2±7.0)mm in diameter.Cyst wall was uniform in 9 cases(42.9%),septa was seen in 14 cases(66.7%),cysts of 16 cases(76.1%)were located in the upper lobes of the lung,1 case(4.7%)had distinctly mediastinal lymph node metastasis.Air-fluid lever,mural nodule or intrapulmonary metastasis were not present in any of the cases.Conclusion The majority of the cystic lung cancer with GGO are adenocarcinoma.In addition of the interference of its prominent cystic features on MSCT,the cystic lung cancer have characteristics of lung cancer with GGO.By analyzing its CT features,diagnostic accuracy can be improved before operation.