OBJECTIVE To investigate the diagnosis and treatment of small cell neuroendocrine carcinoma(SNEC)of nasal cavity and paranasal sinuses.METHODS The clinical data of 5 patients with SNEC diagnosed at Tianjin People's Hospital and Medical University General Hospital from December 2016 to August 2022 were retrospectively analyzed.There were 4 male patients and 1 female patient.The age range was 40-70 years,with an average age of 55 years.Among them,there were 4 stage ⅣA and 1 stage ⅣC.Two patients underwent surgery plus radiotherapy and chemotherapy,one patient underwent radiotherapy followed by chemotherapy,one patient underwent concurrent radiotherapy and chemotherapy,and one patient refused treatment.The follow-up period was 4-60 months.RESULTS By the end of the follow-up,2 patients died,2 patients relapsed,and 1 patient had no recurrence.CONCLUSION Nasal cavity and paranasal sinus neuroendocrine tumors are rare,and small cell neuroendocrine carcinoma is even rarer.The clinical symptoms are not typical,and it is usually discovered at an advanced stage.The malignancy is high,and it is generally treated with a comprehensive approach that includes radiotherapy and chemotherapy.The treatment effect is poor.

Objective:To understand spatial aggregation of lung cancer mortality and its changing trends over the past fifty years in different counties and districts of Shandong Province from 1970 to 2021.Methods:The mortality data of lung cancer were obtained from the death registration system of Shandong province and three retrospective surveys of death cause. The mortality rate and age-standardized mortality rate were used to describe the changing trend of lung cancer in different years, and the contribution value of population factors and non-population factors in lung cancer mortality change was calculated by the mortality differential decomposition method. GeoDa 1.20 and ArcGIS 10.8 software were used for spatial autocorrelation analysis and visualization map display.Results:The crude mortality rate of lung cancer in Shandong Province showed a significant upward trend from 1970 to 2021, rising from 7.22 per 100 000 in 1970-1974 to 62.73 per 100 000 in 2020-2021, with an increase of 7.69 times. Meanwhile, the standardized mortality rate of lung cancer exhibited a trend of increasing first and then decreasing. The differential analysis of lung cancer mortality in different years revealed that changes in crude mortality rates were the result of the combined effects of demographic and non-demographic factors. The proportion of population factors (aging population) leading to an increase in lung cancer mortality rate rose from 2.12% in 1990-1992 to 40.20% in 2020-2021. From a spatial distribution perspective, there were significant regional differences in lung cancer mortality rates among counties (cities, districts) in Shandong Province across different eras. Compared to the period of 1970-1974, the lung cancer mortality rates in all counties and districts in 2020-2021 showed a considerable increase, and there were noticeable changes in the areas of high-high and low-low clustering of lung cancer mortality rates across different eras.Conclusion:There have been significant temporal and spatial changes in the mortality rate of lung cancer in Shandong Province from 1970 to 2021. The crude mortality rate has shown an upward trend, while the standardized mortality rate increases first and then decreases. The concentration of lung cancer mortality rates in counties and districts has also undergone significant changes.

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. Surgical resection remains the preferred treatment modality, offering the potential for cure. However, over half of HCC patients present as intermediate to advanced stages at diagnosis, with multiple factors precluding surgical resection. Conversion therapy represents an important treatment strategy by enabling tumor downstaging, offering future resectability for patients with intermediate-to-advanced HCC who are initially unresectable. This article reviews the relevant concepts and research progress in conversion therapy for HCC.

Objective:To explore the spatial clustering of the mortality rate of cervical cancer in different counties (cities, districts) in Shandong Province from 1970 to 2021 and its 50-year changing trend, so as to provide basis for the implementation and evaluation of prevention and control strategies and programs such as cervical cancer screening, early diagnosis and treatment, human papilloma virus (HPV) vaccination, etc.Methods:The mortality data of cervical cancer were obtained from the death registration system of Shandong Province and the data of three retrospective surveys of death causes. The mortality rate and age-standardized mortality rate (using the population composition of China in 1964) are used to describe the changing trend of cervical cancer in different years. The contribution values of population factors and non-population factors in cervical cancer mortality change are calculated by mortality differential decomposition method. ArcGIS 10.8 software is used for spatial distribution and spatial autocorrelation analysis.Results:From 1970 to 2021, the crude mortality rate and age standardized mortality rate of cervical cancer in Shandong Province showed a trend of first rapid decline and then slow increase. The crude mortality rate and standardized mortality rate of female cervical cancer in Shandong Province in 1970-1974 were the highest, reaching 17.22/10 5 and 13.17/10 5, respectively. In 2004-2005, it dropped to the lowest levels of 1.50/10 5 and 0.83/10 5. Subsequently, it slowly rose to 4.12/10 5 and 1.56/10 5 in 2020-2021. The differential analysis of cervical cancer mortality in different years found that the change of cervical cancer mortality was caused by the combined action of population factors and non-population factors. Among them, demographic factors (aging population) led to the increase of cervical cancer mortality, but non-demographic factors (early diagnosis and treatment, HPV infection level, medical technology level, etc) lead to the decrease of cervical cancer mortality. Compared with 1970-1974, with the passage of time, the absolute values of the contribution values of population factors and non-population factors showed an increasing trend, while the contribution of non-population factors was greater than that of population factors, which led to the decline of cervical cancer mortality. From the perspective of spatial distribution, there were great regional differences in the mortality rate of cervical cancer in different counties of Shandong Province. In 2020-2021, the mortality rate of cervical cancer in all counties decreased to a great extent compared with that in 1970-1974, and the high-high and low-low concentration areas of cervical cancer mortality in different years changed obviously. The high-aggregation areas of the cervical cancer mortality rate in Shandong Province from 2020 to 2021 were mainly distributed in some counties and districts of Linyi City, Zaozhuang City, and Heze City in the southwest. Conclusions:There are significant temporal and spatial changes in the mortality rate of cervical cancer in Shandong Province from 1970 to 2021. According to these trends and their geographical and spatial clustering, prevention and control strategies of cervical cancer in different regions should be further formulated and evaluated.

Gastric cancer (GC) is one of the most common malignant tumors of the digestive system in China. With the progress of immunotherapy research, programmed death receptor-1 (PD-1) inhibitor-based combinatory therapy offers new ideas for the treatment of advanced gastric cancer. In recent years, with the increasing status of immunotherapy in the treatment of advanced gastric cancer, a growing number of domestic and international clinical studies shown that immunotherapy could achieve better efficacy in the neoadjuvant therapy and conversion therapy for patients with advanced gastric cancer. This paper reviews the current research progress on the application of PD-1 inhibitors in the neoadjuvant therapy and conversion therapy of gastric cancer.

Objective:To understand spatial aggregation of lung cancer mortality and its changing trends over the past fifty years in different counties and districts of Shandong Province from 1970 to 2021.Methods:The mortality data of lung cancer were obtained from the death registration system of Shandong province and three retrospective surveys of death cause. The mortality rate and age-standardized mortality rate were used to describe the changing trend of lung cancer in different years, and the contribution value of population factors and non-population factors in lung cancer mortality change was calculated by the mortality differential decomposition method. GeoDa 1.20 and ArcGIS 10.8 software were used for spatial autocorrelation analysis and visualization map display.Results:The crude mortality rate of lung cancer in Shandong Province showed a significant upward trend from 1970 to 2021, rising from 7.22 per 100 000 in 1970-1974 to 62.73 per 100 000 in 2020-2021, with an increase of 7.69 times. Meanwhile, the standardized mortality rate of lung cancer exhibited a trend of increasing first and then decreasing. The differential analysis of lung cancer mortality in different years revealed that changes in crude mortality rates were the result of the combined effects of demographic and non-demographic factors. The proportion of population factors (aging population) leading to an increase in lung cancer mortality rate rose from 2.12% in 1990-1992 to 40.20% in 2020-2021. From a spatial distribution perspective, there were significant regional differences in lung cancer mortality rates among counties (cities, districts) in Shandong Province across different eras. Compared to the period of 1970-1974, the lung cancer mortality rates in all counties and districts in 2020-2021 showed a considerable increase, and there were noticeable changes in the areas of high-high and low-low clustering of lung cancer mortality rates across different eras.Conclusion:There have been significant temporal and spatial changes in the mortality rate of lung cancer in Shandong Province from 1970 to 2021. The crude mortality rate has shown an upward trend, while the standardized mortality rate increases first and then decreases. The concentration of lung cancer mortality rates in counties and districts has also undergone significant changes.

Gastric cancer (GC) is one of the most common malignant tumors of the digestive system in China. With the progress of immunotherapy research, programmed death receptor-1 (PD-1) inhibitor-based combinatory therapy offers new ideas for the treatment of advanced gastric cancer. In recent years, with the increasing status of immunotherapy in the treatment of advanced gastric cancer, a growing number of domestic and international clinical studies shown that immunotherapy could achieve better efficacy in the neoadjuvant therapy and conversion therapy for patients with advanced gastric cancer. This paper reviews the current research progress on the application of PD-1 inhibitors in the neoadjuvant therapy and conversion therapy of gastric cancer.

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. Surgical resection remains the preferred treatment modality, offering the potential for cure. However, over half of HCC patients present as intermediate to advanced stages at diagnosis, with multiple factors precluding surgical resection. Conversion therapy represents an important treatment strategy by enabling tumor downstaging, offering future resectability for patients with intermediate-to-advanced HCC who are initially unresectable. This article reviews the relevant concepts and research progress in conversion therapy for HCC.

Objective:To explore the spatial clustering of the mortality rate of cervical cancer in different counties (cities, districts) in Shandong Province from 1970 to 2021 and its 50-year changing trend, so as to provide basis for the implementation and evaluation of prevention and control strategies and programs such as cervical cancer screening, early diagnosis and treatment, human papilloma virus (HPV) vaccination, etc.Methods:The mortality data of cervical cancer were obtained from the death registration system of Shandong Province and the data of three retrospective surveys of death causes. The mortality rate and age-standardized mortality rate (using the population composition of China in 1964) are used to describe the changing trend of cervical cancer in different years. The contribution values of population factors and non-population factors in cervical cancer mortality change are calculated by mortality differential decomposition method. ArcGIS 10.8 software is used for spatial distribution and spatial autocorrelation analysis.Results:From 1970 to 2021, the crude mortality rate and age standardized mortality rate of cervical cancer in Shandong Province showed a trend of first rapid decline and then slow increase. The crude mortality rate and standardized mortality rate of female cervical cancer in Shandong Province in 1970-1974 were the highest, reaching 17.22/10 5 and 13.17/10 5, respectively. In 2004-2005, it dropped to the lowest levels of 1.50/10 5 and 0.83/10 5. Subsequently, it slowly rose to 4.12/10 5 and 1.56/10 5 in 2020-2021. The differential analysis of cervical cancer mortality in different years found that the change of cervical cancer mortality was caused by the combined action of population factors and non-population factors. Among them, demographic factors (aging population) led to the increase of cervical cancer mortality, but non-demographic factors (early diagnosis and treatment, HPV infection level, medical technology level, etc) lead to the decrease of cervical cancer mortality. Compared with 1970-1974, with the passage of time, the absolute values of the contribution values of population factors and non-population factors showed an increasing trend, while the contribution of non-population factors was greater than that of population factors, which led to the decline of cervical cancer mortality. From the perspective of spatial distribution, there were great regional differences in the mortality rate of cervical cancer in different counties of Shandong Province. In 2020-2021, the mortality rate of cervical cancer in all counties decreased to a great extent compared with that in 1970-1974, and the high-high and low-low concentration areas of cervical cancer mortality in different years changed obviously. The high-aggregation areas of the cervical cancer mortality rate in Shandong Province from 2020 to 2021 were mainly distributed in some counties and districts of Linyi City, Zaozhuang City, and Heze City in the southwest. Conclusions:There are significant temporal and spatial changes in the mortality rate of cervical cancer in Shandong Province from 1970 to 2021. According to these trends and their geographical and spatial clustering, prevention and control strategies of cervical cancer in different regions should be further formulated and evaluated.

Objective:To analyze the trend of incidence and mortality of thyroid cancer and estimate its age-period-cohort effect in Shandong Province from 2012 to 2022.Methods:The Joinpoint regression was used to analyze the trend of incidence and mortality of thyroid cancer and calculate the average annual percentage change (AAPC) based on the data on thyroid cancer from 2012 to 2022. The age-period-cohort model was used to analyze the age-effect, time-effect and cohort-effect of thyroid cancer risk in the population aged over 20 years.Results:From 2012 to 2022, the incidence of thyroid cancer in Shandong province showed a significant upward trend, with an AAPC of 21.68% (95% CI: 19.14%-24.27%, P<0.001). The incidence of females was higher than that of males, and the incidence of urban areas was higher than that of rural areas. The trend of thyroid cancer mortality was relatively stable with an AAPC of -3.04% (95% CI:-8.81%-3.09%, P=0.323). The age effect of incidence increased with age before 60 years old and decreased with age after 60 years old. The incidence peaked in the age group of 55-59. The period effect increased with time. The cohort effect showed that the cohort born before 1957 had a downward trend over time, while the cohort born after 1957 had an upward trend. Conclusion:The incidence of thyroid cancer in Shandong shows a rising trend from 2012 to 2022. Age is an important factor affecting the risk of thyroid cancer. The mortality of thyroid cancer remains stable.