Objective To investigate the general characteristics and treatment processes of patients with advanced esophageal cancer (EC) treated in county- or prefecture-level hospitals in high-incidence areas of EC in China. Methods In this retrospective observational study, electronic medical records of patients with advanced EC were collected from six medical centers in high-incidence areas. Eligible patients had advanced EC and whose first medical contact was documented between January 1, 2022, and June 1, 2024. Descriptive statistical analyses were conducted to evaluate patient characteristics and treatment plans. Results A total of 322 EC patients were included, of whom 230 were male (71.4%). The median age was 69 years. Among the 270 patients with available tumor diagnosis information, 264 patients (97.8%) presented with EC-specific symptoms. Of the 281 patients with pathological data, esophageal squamous cell carcinoma was the predominant type, accounting for 254 cases (90.4%). Among 235 patients with information on the initial diagnostic method, 220 (93.6%) were diagnosed through endoscopy. A total of 216 patients (67.1%) with advanced disease progressed from early or locally advanced stages. Surgical treatment was performed in 126 patients (39.1%), of whom 123 (97.6%) achieved R0 resection, and 71 (56.3%) of them received perioperative treatment. Definitive chemoradiotherapy was administered to 116 patients (36.0%). The median disease-free survival for patients undergoing radical surgery was 13.9 months, while that for patients treated with definitive chemoradiotherapy was 10.6 months. At the advanced stage, lymph node metastasis was observed in 250 patients (77.6%), with mediastinal lymph node metastasis being the most common type. Organ metastasis occurred in 176 patients (54.7%), most frequently involving the lungs, liver, and bones. Most patients (79.8%, 229/287) were from the county or city where the hospoital was loacted, 77.9% (232/298) were covered by resident basic medical insurance, and 88.7% (274/309) of patients initiated advanced treatment at the participating hospitals. Conclusion This study reveals the unique epidemiological, clinical, and pathological characteristics of patients with EC in high-incidence areas of China. The results provide an important reference for further exploration of this disease and its management.

Tumor cell-intrinsic programmed death-ligand 1 (PD-L1) signals mediate tumor initiation, progression and metastasis, but their effects in ameloblastoma (AM) have not been reported. In this comprehensive study, we observed marked upregulation of PD-L1 in AM tissues and revealed the robust correlation between elevated PD-L1 expression and increased tumor growth and recurrence rates. Notably, we found that PD-L1 overexpression markedly increased self-renewal capacity and promoted tumorigenic processes and invasion in hTERT⁺-AM cells, whereas genetic ablation of PD-L1 exerted opposing inhibitory effects. By performing high-resolution single-cell profiling and thorough immunohistochemical analyses in AM patients, we delineated the intricate cellular landscape and elucidated the mechanisms underlying the aggressive phenotype and unfavorable prognosis of these tumors. Our findings revealed that hTERT⁺-AM cells with upregulated PD-L1 expression exhibit increased proliferative potential and stem-like attributes and undergo partial epithelial‒mesenchymal transition. This phenotypic shift is induced by the activation of the PI3K-AKT-mTOR signaling axis; thus, this study revealed a crucial regulatory mechanism that fuels tumor growth and recurrence. Importantly, targeted inhibition of the PD-L1-PI3K-AKT-mTOR signaling axis significantly suppressed the growth of AM patient-derived tumor organoids, highlighting the potential of PD-L1 blockade as a promising therapeutic approach for AM.
Ameloblastoma/metabolism* ; Humans ; B7-H1 Antigen/metabolism* ; Neoplasm Recurrence, Local/pathology* ; Signal Transduction ; Cell Proliferation ; Up-Regulation ; TOR Serine-Threonine Kinases/metabolism* ; Proto-Oncogene Proteins c-akt/metabolism* ; Telomerase/metabolism* ; Jaw Neoplasms/metabolism* ; Epithelial-Mesenchymal Transition ; Animals ; Cell Line, Tumor ; Female ; Male

Objective To explore the value of thyroid nodule fine needle aspiration cytology(FNAC)combined with B-Raf proto-oncogene,serine/threonine kinase(BRAF)gene detection in the differential diagnosis of benign and malignant thyroid tumors.Methods According to the results of pathological examination,198 patients with thyroid nodules were divided into the benign lesion group(n=107)and the malignant lesion group(n=91).All patients underwent ultrasound-guided FNAC,and expression of BRAF gene was detected by real-time fluorescence quantitative polymerase chain reaction.The value of FNAC,BRAF gene detection and combined detection in the differential diagnosis of benign and malignant thyroid tumors was analyzed by Kappa consistency test and receiver operating characteristic(ROC)curves.Results The nodules were mostly under envelope in the malignant lesion group,while in the benign lesion group,which were mostly located within glands(P＜0.05).FNAC results showed that 62 cases with type II Bethesda,26 cases with type III Bethesda,29 cases with type IV Bethesda,14 cases with type V Bethesda and 67 cases with type VI Bethesda.There were significant differences in diagnostic positive rates between FNAC,BRAF gene detection,combined detection and pathological examination(P＜0.05).The area under ROC curve(AUC)of FNAC combined with BRAF gene detection for differentiating benign and malignant thyroid tumors was 0.871(95%CI:0.816-0.914),sensitivity was 90.11%,specificity was 84.11%and Kappa value was 0.737.The AUC of FNAC diagnosis was 0.833(95%CI:0.774-0.882),sensitivity was 76.92%,specificity was 89.72%and Kappa value was 0.672.The AUC of BRAF gene detection was 0.829(95%CI:0.770-0.879),sensitivity was 78.02%,specificity was 87.85%and Kappa value was 0.663.Conclusion FNAC combined with BRAF gene detection can improve differential diagnosis efficiency for benign and malignant thyroid lesions,especially enhancing the diagnostic sensitivity.

Objective To explore the value of thyroid nodule fine needle aspiration cytology(FNAC)combined with B-Raf proto-oncogene,serine/threonine kinase(BRAF)gene detection in the differential diagnosis of benign and malignant thyroid tumors.Methods According to the results of pathological examination,198 patients with thyroid nodules were divided into the benign lesion group(n=107)and the malignant lesion group(n=91).All patients underwent ultrasound-guided FNAC,and expression of BRAF gene was detected by real-time fluorescence quantitative polymerase chain reaction.The value of FNAC,BRAF gene detection and combined detection in the differential diagnosis of benign and malignant thyroid tumors was analyzed by Kappa consistency test and receiver operating characteristic(ROC)curves.Results The nodules were mostly under envelope in the malignant lesion group,while in the benign lesion group,which were mostly located within glands(P＜0.05).FNAC results showed that 62 cases with type II Bethesda,26 cases with type III Bethesda,29 cases with type IV Bethesda,14 cases with type V Bethesda and 67 cases with type VI Bethesda.There were significant differences in diagnostic positive rates between FNAC,BRAF gene detection,combined detection and pathological examination(P＜0.05).The area under ROC curve(AUC)of FNAC combined with BRAF gene detection for differentiating benign and malignant thyroid tumors was 0.871(95%CI:0.816-0.914),sensitivity was 90.11%,specificity was 84.11%and Kappa value was 0.737.The AUC of FNAC diagnosis was 0.833(95%CI:0.774-0.882),sensitivity was 76.92%,specificity was 89.72%and Kappa value was 0.672.The AUC of BRAF gene detection was 0.829(95%CI:0.770-0.879),sensitivity was 78.02%,specificity was 87.85%and Kappa value was 0.663.Conclusion FNAC combined with BRAF gene detection can improve differential diagnosis efficiency for benign and malignant thyroid lesions,especially enhancing the diagnostic sensitivity.

Objective: To describe the status of non-steroidal anti-inflammatory drugs (NSAIDs) use in areas with a high incidence of upper gastrointestinal cancer in China. Methods: This study was based on the National Key Research and Development Program of "National Precision Medicine Cohort of Esophageal Cancer" and "Study on Identification and Prevention of High-risk Populations of Gastrointestinal Malignancies (Esophageal cancer, Gastric cancer and Colorectal cancer)" . From January 2017 to August 2018, 212 villages or communities with a high incidence of esophageal cancer or gastric cancer were selected from 12 regions in 6 provinces. A total of 35 910 residents aged between 40 and 69 years old who met the inclusion criteria and signed the informed consent were investigated and enrolled in this study. The use of NSAIDs, demographic characteristics, health-related habits, height, weight, and blood pressure were collected by the questionnaire and physical examination. The status of main NSAIDs (aspirin, acetaminophen and ibuprofen) use with the difference varying in genders, age groups and regions were analyzed by using χ² test and Cochran-Armitage trend analysis method. Results: Of 35 910 subjects, the mean age was (54.6±7.1) years old and males accounted for 43.42% (15 591). The overall prevalence of NSAIDs intake was 4.56% (1 638), but it significantly varied in different provinces (P<0.001). The overall prevalence of NSAIDs intake was 4.87% (1 750) in females, which was significantly higher than that in males 4.24% (1 524) (P<0.001). The prevalence of NSAIDs intake increased with age (P for trend <0.001). As the frequency of NSAIDs intake increased, the incidence of gastrointestinal symptoms, gastrointestinal ulcers and black stools increased (P for trend <0.05 for all). Conclusion The use of NSAIDs is prevalent in some areas with a high incidence of upper gastrointestinal cancer in China. The increased use of NSAIDs may lead to more adverse effects related to the gastrointestinal tract.