1.Clinicopathological and molecular mechanisms of CLDN18.2 in gastric cancer aggressiveness: a high-risk population study with multi-omics profiling
Hengquan WU ; Mei LI ; Gang WANG ; Peiqing LIAO ; Peng ZHANG ; Luxi YANG ; Yumin LI ; Tao LIU ; Wenting HE
Journal of Pathology and Translational Medicine 2026;60(1):47-57
Background:
The tight junction protein claudin18.2 (CLDN18.2) has been implicated in poor prognosis and suboptimal immunotherapy response in gastric cancer (GC). This study investigates the clinicopathological relevance of CLDN18.2 expression and its association with molecular subtypes in GC patients from a high-incidence region, combining transcriptomic and proteomic approaches to explore how CLDN18.2 contributes to progression and metastasis.
Methods:
A retrospective cohort of 494 GC patients (2019–2024) underwent immunohistochemical analysis for CLDN18.2, Epstein-Barr virus (Epstein–Barr virus–encoded RNA), p53, human epidermal growth factor receptor 2 (HER2), and mismatch repair proteins (MLH1, MSH2, PMS2, and MSH6). CLDN18.2 positivity was defined as moderate to strong (2+/3+) membranous staining in ≥75% of tumor cells. Clinicopathological correlations, biomarker associations, and survival outcomes were evaluated. Transcriptomic and proteomic sequencing was performed to explore molecular mechanisms.
Results:
CLDN18.2 positivity was observed in 26.9% (133/494) of gastric adenocarcinomas. CLDN18.2-positive tumors correlated with TNM stage (p = .003) and shorter overall survival (p = .018). No associations were identified with age, sex, HER2 status, microsatellite instability, or Epstein-Barr virus infection. Transcriptomic profiling revealed CLDN18.2-high tumors enriched in pathways involving cell junction disruption, signaling regulation, and immune modulation. Proteomic profiling showed that tumors with high CLDN18.2 were enriched in multiple mechanism-related pathways such as integrated metabolic reprogramming, cytoskeletal recombination, immune microenvironment dysregulation, and pro-survival signaling. These mechanisms may collectively contribute to tumor progression and metastasis.
Conclusions
CLDN18.2 overexpression is associated with poor prognosis in GC patients. Transcriptomic and proteomic analyses demonstrate that CLDN18.2 promotes tumor progression and metastasis, underscoring its potential as an independent prognostic factor in regions with a high incidence of GC.
2.USP51/GRP78/ABCB1 axis confers chemoresistance through decreasing doxorubicin accumulation in triple-negative breast cancer cells.
Yang OU ; Kun ZHANG ; Qiuying SHUAI ; Chenyang WANG ; Huayu HU ; Lixia CAO ; Chunchun QI ; Min GUO ; Zhaoxian LI ; Jie SHI ; Yuxin LIU ; Siyu ZUO ; Xiao CHEN ; Yanjing WANG ; Mengdan FENG ; Hang WANG ; Peiqing SUN ; Yi SHI ; Guang YANG ; Shuang YANG
Acta Pharmaceutica Sinica B 2025;15(5):2593-2611
Recent studies have indicated that the expression of ubiquitin-specific protease 51 (USP51), a novel deubiquitinating enzyme (DUB) that mediates protein degradation as part of the ubiquitin‒proteasome system (UPS), is associated with tumor progression and therapeutic resistance in multiple malignancies. However, the underlying mechanisms and signaling networks involved in USP51-mediated regulation of malignant phenotypes remain largely unknown. The present study provides evidence of USP51's functions as the prominent DUB in chemoresistant triple-negative breast cancer (TNBC) cells. At the molecular level, ectopic expression of USP51 stabilized the 78 kDa Glucose-Regulated Protein (GRP78) protein through deubiquitination, thereby increasing its expression and localization on the cell surface. Furthermore, the upregulation of cell surface GRP78 increased the activity of ATP binding cassette subfamily B member 1 (ABCB1), the main efflux pump of doxorubicin (DOX), ultimately decreasing its accumulation in TNBC cells and promoting the development of drug resistance both in vitro and in vivo. Clinically, we found significant correlations among USP51, GRP78, and ABCB1 expression in TNBC patients with chemoresistance. Elevated USP51, GRP78, and ABCB1 levels were also strongly associated with a poor patient prognosis. Importantly, we revealed an alternative intervention for specific pharmacological targeting of USP51 for TNBC cell chemosensitization. In conclusion, these findings collectively indicate that the USP51/GRP78/ABCB1 network is a key contributor to the malignant progression and chemotherapeutic resistance of TNBC cells, underscoring the pivotal role of USP51 as a novel therapeutic target for cancer management.
3.Evaluation of 18F-FDG PET/CT SUVmax and T/MB ratio in assessing aggressiveness and predicting therapeutic efficacy in non-Hodgkin's lymphoma
Chuanqin ZHANG ; Qi HUANG ; Peiqing YANG ; Zelong FENG ; Fang LI ; Xiaoping LI ; Pan WANG
Chinese Journal of Immunology 2025;41(11):2645-2650
Objective:To investigate factors influencing 18F-FDG PET/CT SUVmax,T/MB ratio and Ki-67 expression in non-Hodgkin's lymphoma(NHL),to analyze their correlations with lymphoma aggressiveness and their potential advantages in predicting therapeutic efficacy.Methods:A retrospective analysis was conducted to investigate correlations between tumor SUVmax,T/MB ratio,and Ki-67 expression with NHL aggressiveness and clinical characteristics in 99 patients;whether SUVmax,T/MB ratio and Ki-67 served as independent prognostic factors influencing therapeutic efficacy was examined,and potential utility of ΔSUVmax and ΔT/MB as biomarkers for treatment response assessment were evaluated.Results:Aggressive NHL demonstrated significantly higher SUVmax,T/MB ratio and Ki-67 level compared to indolent NHL and aggressive/indolent NHL(P<0.05).A pretreatment SUVmax≥9.05,T/MB≥5.115 or Ki-67≥55%could predict clinical remission in NHL patients post-treatment,while post-treatment reductions of ΔSUVmax≥22.65%or ΔT/MB≥34.85%were associated with achieved clinical remission.Conclusion:SUVmax,T/MB ratio and Ki-67 are closely associated with aggressiveness of NHL,which can be predicted whether NHL will be relieved after treatment.ΔSUVmax and ΔT/MB can assess whether NHL has been relieved after treatment.
4.Evaluation of 18F-FDG PET/CT SUVmax and T/MB ratio in assessing aggressiveness and predicting therapeutic efficacy in non-Hodgkin's lymphoma
Chuanqin ZHANG ; Qi HUANG ; Peiqing YANG ; Zelong FENG ; Fang LI ; Xiaoping LI ; Pan WANG
Chinese Journal of Immunology 2025;41(11):2645-2650
Objective:To investigate factors influencing 18F-FDG PET/CT SUVmax,T/MB ratio and Ki-67 expression in non-Hodgkin's lymphoma(NHL),to analyze their correlations with lymphoma aggressiveness and their potential advantages in predicting therapeutic efficacy.Methods:A retrospective analysis was conducted to investigate correlations between tumor SUVmax,T/MB ratio,and Ki-67 expression with NHL aggressiveness and clinical characteristics in 99 patients;whether SUVmax,T/MB ratio and Ki-67 served as independent prognostic factors influencing therapeutic efficacy was examined,and potential utility of ΔSUVmax and ΔT/MB as biomarkers for treatment response assessment were evaluated.Results:Aggressive NHL demonstrated significantly higher SUVmax,T/MB ratio and Ki-67 level compared to indolent NHL and aggressive/indolent NHL(P<0.05).A pretreatment SUVmax≥9.05,T/MB≥5.115 or Ki-67≥55%could predict clinical remission in NHL patients post-treatment,while post-treatment reductions of ΔSUVmax≥22.65%or ΔT/MB≥34.85%were associated with achieved clinical remission.Conclusion:SUVmax,T/MB ratio and Ki-67 are closely associated with aggressiveness of NHL,which can be predicted whether NHL will be relieved after treatment.ΔSUVmax and ΔT/MB can assess whether NHL has been relieved after treatment.
5.Incidence, mortality, and disability-adjusted life years of female breast cancer in China, 2022
Kexin SUN ; Bailin ZHANG ; Shaoyuan LEI ; Rongshou ZHENG ; Xin LIANG ; Li LI ; Xiaolong FENG ; Siwei ZHANG ; Hongmei ZENG ; Yifei YAO ; Peiqing MA ; Shaoming WANG ; Ru CHEN ; Bingfeng HAN ; Wenqiang WEI ; Jie HE
Chinese Medical Journal 2024;137(20):2429-2436
Background::Breast cancer is ranked among the most prevalent malignancies in the Chinese female population. However, comprehensive reports detailing the latest epidemiological data and attributable disease burden have not been extensively documented.Methods::In 2018, high-quality cancer surveillance data were recorded in 700 population-based cancer registries in China. We extracted data on female breast cancers (International Classification of Diseases, Tenth Revision [ICD-10]: C50) and estimated the incidence and mortality in 2022 according to the baseline data and corresponding trends from 2010 to 2018. Pathological types were classified according to the ICD for Oncology, 3rd Edition codes. Disability-adjusted life years (DALYs) were calculated as the sum of the years of life lost (YLLs) and years lived with disability (YLDs).Results::In 2022, approximately 357,200 new female breast cancer cases and 75,000 deaths occurred in China, accounting for 15.59% and 7.94% of total new cancer cases and deaths, respectively. The age-standardized incidence rate (ASIR) was 33.04 per 100,000. When analyzed by pathological type, the ASIRs for papillary neoplasms, invasive breast carcinoma, rare and salivary gland-type tumors, and other types were 1.13, 29.79, 0.24, and 1.88 per 100,000, respectively. The age-standardized mortality rate (ASMR) was 6.10 per 100,000. A total of 2,628,000 DALYs were found to be attributable to female breast cancer in China, comprising 2,278,300 YLLs and 349,700 YLDs. The ASIR, ASMR, and age-standardized rate (ASR) for DALYs in urban areas were consistently higher than those in rural areas. We observed a four-fold increase in the ASIR and ASR for DALYs and an eight-fold increase in the ASMR among females over 55 years compared with those aged under 55 years.Conclusion::These data provide invaluable insights into the latest epidemiology of female breast cancer in China and highlight the urgency for disease prevention and control strategy formulation.
6.Construction and evaluation of diabetic atherosclerosis model in LDLR-/-mice in-duced by STZ and fed with high-fat diet
Li WANG ; Jinning GAO ; Xiangyun CHEN ; Peiqing JIANG ; Mei LI ; Fangfang BU ; Mei ZHANG ; Guihua YAO ; Hui SUN
Chinese Journal of Arteriosclerosis 2024;32(11):985-993
Aim To construct a diabetic atherosclerosis mouse model and study the pathological characteristics of diabetic atherosclerosis.Methods Fifty 8-week-old male LDLR-/-mice were fed with standard diet for 2 weeks and then changed to high-fat diet,they were randomly divided into two groups.The diabetic atherosclerosis group was given intraperitoneal injection of low dose streptozotocin(STZ)for 5 days continuouly to establish the model,and the atheroscle-rosis group was given citrate buffer injection at the same time.The body mass,blood glucose and blood lipids of the mice in the two groups were detected for many times.At the age of 23 weeks,the mice were euthanized after glucose tolerance test.HE staining and oil red O staining were used to detect the gross and aortic root atherosclerosis,immunohistochemical staining was used to detect CD4,α-smooth muscle actin(α-SMA),EGF-like module-containing mucin-like hormone re-ceptor-like 1(EMR1),monocyte chemotactic protein-1(MCP-1),NOD-like receptor protein 3(NLRP3),vascular cell adhesion molecule-1(VCAM-1),matrix metalloproteinase-2(MMP-2)and tissue inhibitor of metalloproteinase-1(TIMP-1),Western blot was used to detect α-SMA,CD4,tumor necrosis factor-α(TNF-α),NLPR3,intercellular adhesion molecule-1(ICAM-1),and type Ⅰ and Ⅲ collagen.Results Compared with the atherosclerosis group,the body mass decreased,the levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDLC)increased,and the levels of high density lipoprotein cholesterol(HDLC)decreased(P<0.05)in the diabetic atherosclerosis group.Compared with the atherosclerosis group,the distribution of atherosclerotic plaques was diffuse and the area was increased in the diabetic atherosclerosis group,and the contents of lipids,T cells,macrophages,smooth muscle cells,type Ⅰ and Ⅲ colla-gen were increased(P<0.05);the protein levels of TNF-α,MCP-1,MMP-2,NLRP3,ICAM-1 and VCAM-1 in vascular tissues were increased,while the content of TIMP-1 were decreased and MMP2/TIMP-1 were increased(P<0.05).Conclusions LDLR-mouse model of diabetic atherosclerosis can be successfully established by STZ induction combined with high-fat diet,which can reflect the plaque composition and inflammatory characteristics of diabetes promoting atheroscle-rosis.It can be used as a relatively ideal pathological model for the study of diabetic macroangiopathy.
7.Diagnostic value of ACR TI-RADS combined with three-dimensional shear wave elastography in ACR TI-RADS 4 and 5 thyroid nodules.
Lijun HAO ; Peiqing LIU ; Changwei DING ; Jing LI ; Yingchun ZHANG
Chinese Medical Journal 2023;136(10):1225-1230
BACKGROUND:
Three-dimensional shear wave elastography (3D-SWE) is a promising method in distinguishing benign and malignant thyroid nodules. By combining with conventional method, it may further improve the diagnostic value. The study aimed to assess the diagnostic value of American College of Radiology (ACR) thyroid imaging reporting and data system (TI-RADS) combined with 3D-SWE in ACR TI-RADS 4 and 5 thyroid nodules.
METHODS:
All nodules were examined by conventional ultrasonography, ACR TI-RADS classification, and 3D-SWE examination. Conventional ultrasonography was used to observe the location, size, shape, margin, echogenicity, taller-than-wide sign, microcalcification, and blood flow of thyroid nodules, and then ACR TI-RADS classification was performed. The Young's modulus values (3D-C-Emax, 3D-C-Emean, and elastography standard deviation [3D-C-Esd]) were measured on the reconstructed coronal plane images. According to the receiver operating characteristic (ROC) curve, the best diagnostic efficiency among 3D-C-Emax, 3D-C-Emean, and 3D-C-Esd was selected and the cut-off threshold was calculated. According to the surgical pathology, they were divided into benign group and malignant group. And appropriate statistical methods such as t -test and Mann-Whitney U test were used to compare the difference between the two groups. On this basis, 3D-SWE combined with conventional ACR TI-RADS was reclassified as combined ACR TI-RADS to determine benign or malignant thyroid nodules.
RESULTS:
Of the 112 thyroid nodules, 62 were malignant and 50 were benign. The optimal cut-off value of three-dimensional maximum Young's modulus in coronal plane (3D-C-Emax) was 51.5 kPa and the area under the curve (AUC) was 0.798. The AUC, sensitivity, specificity, and accuracy of conventional ACR TI-RADS were 0.828, 83.9%, 66.0%, and 75.9%, respectively. The AUC, sensitivity, specificity, and accuracy of combined ACR TI-RADS were 0.845, 90.3%, 66.0%, and 79.5%, respectively. The difference between the two AUC values was statistically significant.
CONCLUSIONS
Combined ACR TI-RADS has higher diagnostic efficiency than conventional ACR TI-RADS. The sensitivity and accuracy of combined ACR TI-RADS showed significant improvements. It can be used as an effective method in the diagnosis of thyroid nodules.
Humans
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Thyroid Nodule/pathology*
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Elasticity Imaging Techniques/methods*
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Retrospective Studies
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Ultrasonography/methods*
8.Effect of Banxia Xiexintang-containing Intestinal Absorption Solution on Migration and Invasion of PMN-MDSCs in Gastric Cancer Microenvironment
Jingjing WEI ; Zhongbo ZHU ; Xiping LIU ; Peiqing LI ; Qiming CHEN ; Lirong DAI ; Lijuan SHI ; Haijing DUAN ; Qingmiao WANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(10):48-57
ObjectiveTo observe the effect of Banxia Xiexintang containing intestinal absorption solution (BXCIAS) on migration and invasion of polymorphonuclear myeloid-derived suppressor cells (PMN-MDSCs) in gastric cancer microenvironment. MethodThe complex solution (containing 0.63 g·mL-1 crude drug) was prepared. Gastric cancer cells were subjected to non-contact co-culture with PMN-MDSCs in Transwell chamber to create gastric cancer microenvironment. Cell counting kit-8 (CCK-8) assay was used to screen the optimal intervention concentration and time of BXCIAS on PMN-MDSCs for subsequent experiment. The blank group, model group, FAK inhibitor group, and BXCIAS groups (26%, 18%, and 10%) were designed. Scratch assay and Transwell assay were employed to detect the migration and invasion ability of PMN-MDSCs, and enzyme-linked immunosorbent assay (ELISA) to measure the expression of vascular endothelial cell growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) in tumor microenvironment. The expression levels of PMN-MDSCs pathway-related proteins FAK, phosphorylated (p)-FAK, protein tyrosine kinase (Src), and p-Src were detected by Western blot. ResultThe inhibition rates of PMN-MDSCs by 5%, 50%, 75%, and 100% BXCIAS at 48 h were higher than those at 24 h (P<0.05, P<0.01). The inhibition rate of PMN-MDSCs by 50% BXCIAS at 72 h was lower than that at 48 h (P<0.01), and the inhibition rates by 5% and 100% BXCIAS at 72 h were higher than those at 48 h (P<0.05, P<0.01). There was no significant difference in the inhibition rate by other concentration levels at 48 h. The half-maximal inhibitory concentration (IC50) at 48 h was 18.09%, indicating that 18% BXCIAS and 48 h were the optimal concentration and time, respectively. The migration distance of PMN-MDSCs was large (P<0.01), and the number of migrating and invading cells increased (P<0.01) in the mode group compared with those in the blank group. Compared with model group, FAK inhibitor and BXCIAS at different concentration decreased the migration distance of PMN-MDSCs (P<0.01), and the number of migrating and invading cells (P<0.01), especially the 26% BXCIAS (P<0.01). The expression of PMN-MDSCs pathway-related proteins FAK, p-FAK, Src and p-Src (P<0.01) and the expression of VEGF and MMP-9 (P<0.01) were higher in the model group than in the blank group. Compared with model group, FAK inhibitor and BXCIAS (26%, 18%, 10%) decreased the expression of FAK, p-FAK, and Src (P<0.01), and FAK inhibitor and 18% BXCIAS reduced the expression of p-Src (P<0.01), and the expression of VEGF and MMP-9 (P<0.01). ConclusionBXCIAS can inhibit the migration and invasion of PMN-MDSCs by down-regulating the expression of FAK, p-FAK, Src, and p-Src proteins in the FAK signaling pathway of PMN-MDSCs in gastric cancer microenvironment.
9.Effect of Banxia Xiexintang-containing Intestinal Absorption Solution on PMN-MDSCs Apoptosis in Gastric Cancer Microenvironment
Jingjing WEI ; Zhongbo ZHU ; Xiping LIU ; Peiqing LI ; Qiming CHEN ; Lirong DAI ; Lijuan SHI ; Haijing DUAN ; Qingmiao WANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(10):58-64
ObjectiveTo observe the effect of Banxia Xiexintang (BXT)-containing intestinal absorption solution on the apoptosis of polymorphonuclear myeloid-derived suppressor cells (PMN-MDSCs) in gastric cancer microenvironment. MethodBXT-containing intestinal absorption solution was prepared, and gastric cancer cells and PMN-MDSCs were non-contact co-cultured in Transwell chamber to establish gastric cancer microenvironment. Cell counting kit-8 (CCK-8) assay was used to screen the optimal intervention concentration and time of 0-100% BXT-containing intestinal absorption solution prepared by 0.63 g·mL-1 reconstitution solution. Cells were classified into blank group, model group, oxaliplatin group (10 mg·L-1), and BXT (26%, 18%, 10% BXT-containing intestinal absorption solution) group, and the apoptosis of PMN-MDSCs was detected by flow cytometry. The expression of apoptosis-related B-cell lymphoma 2 (Bcl-2), Bcl-2-associated X protein (Bax), and cysteine-aspartic acid protease-3 (Caspase-3) in PMN-MDSCs was detected by Western blot. ResultAfter treatment for 24 h and 48 h, the PMN-MDSCs-inhibiting rate was increased by 5%, 50%, 75%, and 100% BXT-containing intestinal absorption solution compared with that in the blank group (P<0.05, P<0.01). At 72 h, the PMN-MDSCs-inhibiting rate by 50% BXT-containing intestinal absorption solution was lower than that at 48 h (P<0.01), and the PMN-MDSCs-inhibiting rate by 5%, 75%, and 100% BXT-containing intestinal absorption solution showed no significant difference from that at 48 h. Moreover, the half-maximal inhibitory concentration (IC50) at 48 h was 18.40%. Thus, 18% BXT-containing intestinal absorption solution and 48 h were the optimal intervention concentration and time. The survival rate of PMN-MDSCs in model group was higher than that in the blank group (P<0.05), and the apoptosis rate was lower than that in the blank group (P<0.05). Compared with model group, BXT containing intestinal absorption solution lowered the survival rate and raised apoptosis rate of PMN-MDSCs (P<0.05), particularly the 26% BXT-containing intestinal absorption solution (P<0.05). The expression of Bax and Caspase-3 in PMN-MDSCs was lower in the model group than in the blank group (P<0.05), and the expression of Bcl-2 was higher in the model group than in the blank group (P<0.05). The expression of Caspase-3 in PMN-MDSCs increased (P<0.05) and the expression of Bcl-2 decreased (P<0.05) in oxaliplatin group and BXT group compared with those in the model group. The expression of Bax rose in oxaliplatin group and BXT group (10% BXT-containing intestinal absorption solution) (P<0.05). ConclusionBXT can induce the apoptosis of PMN-MDSCs by regulating the expression of apoptosis-related proteins Bax, Caspase-3, and Bcl-2 in gastric cancer microenvironment.
10.Mechanism of Banxia Xiexintang in Prevention and Treatment of Gastric Cancer: A Review
Yanmei ZHANG ; Jingjing WEI ; Zhongbo ZHU ; Senyu LIU ; Fan YANG ; Xiping LIU ; Peiqing LI
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(10):65-72
Gastric cancer (GC) is one of the common malignant tumors, and the incidence and mortality of GC in China rank first in the world. At present, the pathogenesis of GC has not been fully clarified. Although surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy have achieved good results in the treatment of GC, there are still many complications, decreased sensitivity, and severe side effects. Banxia Xiexintang, derived from Treatise on Cold Damage and Miscellaneous Diseases(《伤寒杂病论》), has been clinically used for more than 2000 years with the effects of combining cold and warm drugs, dissipating mass, and relieving stuffiness, and is a classic prescription for treating digestive tract diseases in later generations. Through clinical observation and experimental research, it is found that Banxia Xiexintang and its single drugs have good effect in preventing and treating GC. Chinese medicine has multi-component and multi-target characteristics and can treat GC through various mechanisms. Therefore, it is necessary to carry out systematic and in-depth research from the aspects of molecular biology and network pharmacology, and comprehensively reveal the mechanism of Banxia Xiexintang in preventing and treating GC. At present, the mechanism of Banxia Xiexintang in treating GC mainly focuses on inducing apoptosis of GC cells, inhibiting proliferation, migration, and invasion of GC cells, protecting peritoneal mesothelial cells, inhibiting peritoneal metastasis of GC cells, regulating GC microenvironment, and inhibiting the malignant transformation of bone marrow mesenchymal stem cells (BMSCs). This research group is committed to the prevention and treatment of GC with Banxia Xiexintang, aiming to comprehensively reveal the mechanism of action and the pharmacodynamic material basis of Banxia Xiexintang in the prevention and treatment of GC, and provide an important scientific basis for further clinical application of Banxia Xiexintang. After searching CNKI, PubMed, Wanfang Data, VIP, and other databases, this paper summarized Banxia Xiexintang in the treatment of GC from the aspects of prescription basis, material basis, network pharmacology, clinical and experimental studies, etc., so as to provide references for further research on pharmacological effect of Banxia Xiexintang and its application in the clinical treatment of GC.

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