1.Correct understanding of pathological evaluation and prognostic value of the invasion depth of early colorectal cancer (pT1)
Chinese Journal of Pathology 2025;54(11):1117-1123
Colorectal cancer (CRC) is one of the most malignant tumors with high morbidity and mortality worldwide. Early diagnosis and accurate pathological evaluation are of great significance for improving patient prognosis. Endoscopic resection is the main treatment for early CRC. Pathological parameters-such as margin status, lymphatic vascular invasion (LVI), tumor grade, depth of submucosal invasion and tumor budding are the key to determine whether curative resection is achieved. At present, the measurement method of submucosal invasion depth of pT1 CRC is controversial. Submucosal invasion depth measurement adopts different measurement methods for pedunculated and sessile lesions, mainly including measurement from the surface of the lesion or the lower edge of the mucosal muscle layer. Especially for sessile lesions, due to different observers different understandings of the position of the mucosal muscle layer that can be identified or evaluated in the guidelines, observers may apply different criteria to evaluate the integrity of the mucosal muscle layer. In recent years, more and more evidence has shown that the association between the depth of submucosal invasion and the risk of lymph node metastasis may be overestimated, while other pathological parameters (such as LVI, high-grade tumor budding, and poorly differentiated components) have equal or more important significance in prognostic stratification. Therefore, the current measurement of the depth of submucosal invasion of pT1 CRC and its prognostic value are facing challenges, which deserve our attention and further exploration.
2.Tissue and plasma proteomic signatures associated with the risk of gastric cancer
Lanxin YANG ; Kaosaier AINIWAER ; Xue LI ; Hengmin XU ; Tong ZHOU ; Yang ZHANG ; Jingying ZHANG ; Weicheng YOU ; Kaifeng PAN ; Wenqing LI
Chinese Journal of Preventive Medicine 2025;59(3):302-308
Objective:To identify proteins associated with the risk of gastric cancer (GC) and build a protein risk score for risk prediction of GC based on proteomic analysis.Methods:Gastric mucosal proteomics data were used to construct Dataset One, comprising 94 GC cases and 230 individuals with different stages of gastric mucosal lesions. The GC cases were recruited from the National Upper Gastrointestinal Cancer Early Detection (UGCED) Program in Linqu, Shandong Province, as well as clinical patients from the Fifth Medical Center, General Hospital of PLA, and Peking University Cancer Hospital. Non-cancer individuals were enrolled from the National UGCED Program in Linqu and community screening programs at the Dongfang Hospital. All participants were pathologically confirmed. Multivariate logistic regression analysis was employed to identify gastric mucosal proteins significantly associated with GC risk. Subsequently, plasma proteomics data from the UK Biobank Pharma Proteomics Project (UKB-PPP) were used to construct Dataset Two, including 40 baseline GC cases and 47 933 non-cancer individuals, and Dataset Three, comprising 138 incident GC cases and 47 933 non-cancer individuals during a prospective follow-up period. In Dataset Two, multivariate logistic regression analysis was conducted to assess associations between plasma protein levels and baseline GC risk. In Dataset Three, multivariate Cox regression analysis was used to examine associations with the risk of incident GC. A poly-protein risk score (PRS) was developed using a weighted summation method based on protein effect sizes from Dataset Two. Its associations with GC risk and the progression of gastric mucosal lesions were evaluated using linear regression trend tests.Results:A total of 324, 47 973 and 48 071 participants were included in Datasets One, Two, and Three, respectively. Across the three datasets, the proportions of males and individuals aged>60 years were higher in the GC group than in the non-GC group (all P values<0.05). The follow-up period in Dataset Three had a M ( P 25, P 75) of 14.47 (13.7, 15.2) years, with a median of 7.4 (4.6, 11.3) years for those who progressed to GC. Based on Dataset One, 2 524 tissue-differential proteins associated with GC risk were identified through multivariate logistic regression analysis adjusted for age and sex. Among these, seven proteins were consistently associated with GC risk across tissue and plasma levels in Datasets Two and Three, with consistent directions of association. Five proteins (MRC1, APOL1, BST2, PON2, and GGH) were positively associated with GC risk, while two (GSN and CLEC3B) were negatively associated. Analysis of the PRS based on these seven proteins showed that for each standard deviation increase in the tissue-derived PRS, the risk of GC increased by 6.26 times (95% CI: 4.02-9.75). In Dataset Two, each standard deviation increase in the plasma-derived PRS was associated with a 2.13-fold increase in GC risk (95% CI: 1.68-2.69). In the prospective cohort of Dataset Three, individuals in the high PRS group had a 2.27-fold higher risk of GC compared to the low PRS group (95% CI: 1.50-3.45). Moreover, each standard deviation increase in the plasma PRS was associated with a 57% higher risk of GC ( HR=1.57, 95% CI: 1.34-1.84). Additionally, the tissue-derived PRS showed an increasing trend with the progression of gastric mucosal lesions. Conclusion:The tissue and plasma proteomics identified seven individual proteins that may indicate the risk of developing gastric cancer, showing the potential as biomarkers for aiding in the screening of gastric cancer.
3.Application of resting-state electroencephalography in assessment of upper limb motor function of stroke patients
Xinlei LI ; Wei WEI ; Jian SONG ; Yuqing ZHAO ; Weicheng KONG ; Jiayu CAI ; Haoran SHI ; Xiehua XUE
Chinese Journal of Rehabilitation Theory and Practice 2025;31(4):448-457
Objective To investigate the features of resting-state electroencephalography(EEG)in stroke patients with limited upper limb movement,and assess its potential utility in evaluating upper limb motor function.Methods From March to August,2024,a total of 71 stroke patients with limited upper limb movement were enrolled as stroke group at the Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine;while 63 healthy participants matched for age and sex were recruited as control group.They were tested with 19-chan-nel resting-state EEG(rsEEG),calculating of the pairwise derived brain symmetry index(pdBSI)and Delta/Al-pha ratio(DAR).The motor function was assessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),the upper limb recovery was evaluated with Brunnstrom Stages and the activities of daily living was assessed with modified Barthel index(MBI)in stroke patients,Results Compared with the control group,the pdBSI of Global lead,Frontal region,Central region and Posterior region across Delta,Alpha and Beta1 frequency bands were significantly higher in the stroke group than in the control group(|Z|>2.289,P<0.05);as well as the pdBSI of Global lead,Central region and Posterior region across The-ta bands(|Z|>3.016,P<0.01),the pdBSI of Global lead,Frontal region,Central region and Posterior region across Beta2 bands(|Z|>3.222,P<0.01),DAR of Global lead,Frontal region,Central region and Posterior re-gion(|Z|>6.565,P<0.001).In the stroke group,the pdBSI of Global lead(r=-0.280,P=0.018)and Central region(r=-0.304,P=0.010)across the Delta band were significantly negatively correlated with FMA-UE,as well as the pdBSI of Global leads(r=-0.289,P=0.014),Central region(r=-0.244,P=0.040)and Posterior region(r=-0.356,P=0.002)across the Beta1 band,and the DAR of Global lead(r=-0.431,P<0.001),Fron-tal region(r=-0.429,P<0.001),Central region(r=-0.491,P<0.001)and Posterior region(r=-0.482,P<0.001).Conclusion Asymmetry in spectral power between hemispheres in the Delta(0.5 to 4 Hz)and Beta(13 to 20 Hz)bands is found in stroke patients,especially in the central region,which correlates with upper limb function limitations.pdBSI Delta,pdBSI Beta1 and DAR are potential neuroelectrophysiological markers for assessing upper limb motor function in stroke patients.
4.Tissue and plasma proteomic signatures associated with the risk of gastric cancer
Lanxin YANG ; Kaosaier AINIWAER ; Xue LI ; Hengmin XU ; Tong ZHOU ; Yang ZHANG ; Jingying ZHANG ; Weicheng YOU ; Kaifeng PAN ; Wenqing LI
Chinese Journal of Preventive Medicine 2025;59(3):302-308
Objective:To identify proteins associated with the risk of gastric cancer (GC) and build a protein risk score for risk prediction of GC based on proteomic analysis.Methods:Gastric mucosal proteomics data were used to construct Dataset One, comprising 94 GC cases and 230 individuals with different stages of gastric mucosal lesions. The GC cases were recruited from the National Upper Gastrointestinal Cancer Early Detection (UGCED) Program in Linqu, Shandong Province, as well as clinical patients from the Fifth Medical Center, General Hospital of PLA, and Peking University Cancer Hospital. Non-cancer individuals were enrolled from the National UGCED Program in Linqu and community screening programs at the Dongfang Hospital. All participants were pathologically confirmed. Multivariate logistic regression analysis was employed to identify gastric mucosal proteins significantly associated with GC risk. Subsequently, plasma proteomics data from the UK Biobank Pharma Proteomics Project (UKB-PPP) were used to construct Dataset Two, including 40 baseline GC cases and 47 933 non-cancer individuals, and Dataset Three, comprising 138 incident GC cases and 47 933 non-cancer individuals during a prospective follow-up period. In Dataset Two, multivariate logistic regression analysis was conducted to assess associations between plasma protein levels and baseline GC risk. In Dataset Three, multivariate Cox regression analysis was used to examine associations with the risk of incident GC. A poly-protein risk score (PRS) was developed using a weighted summation method based on protein effect sizes from Dataset Two. Its associations with GC risk and the progression of gastric mucosal lesions were evaluated using linear regression trend tests.Results:A total of 324, 47 973 and 48 071 participants were included in Datasets One, Two, and Three, respectively. Across the three datasets, the proportions of males and individuals aged>60 years were higher in the GC group than in the non-GC group (all P values<0.05). The follow-up period in Dataset Three had a M ( P 25, P 75) of 14.47 (13.7, 15.2) years, with a median of 7.4 (4.6, 11.3) years for those who progressed to GC. Based on Dataset One, 2 524 tissue-differential proteins associated with GC risk were identified through multivariate logistic regression analysis adjusted for age and sex. Among these, seven proteins were consistently associated with GC risk across tissue and plasma levels in Datasets Two and Three, with consistent directions of association. Five proteins (MRC1, APOL1, BST2, PON2, and GGH) were positively associated with GC risk, while two (GSN and CLEC3B) were negatively associated. Analysis of the PRS based on these seven proteins showed that for each standard deviation increase in the tissue-derived PRS, the risk of GC increased by 6.26 times (95% CI: 4.02-9.75). In Dataset Two, each standard deviation increase in the plasma-derived PRS was associated with a 2.13-fold increase in GC risk (95% CI: 1.68-2.69). In the prospective cohort of Dataset Three, individuals in the high PRS group had a 2.27-fold higher risk of GC compared to the low PRS group (95% CI: 1.50-3.45). Moreover, each standard deviation increase in the plasma PRS was associated with a 57% higher risk of GC ( HR=1.57, 95% CI: 1.34-1.84). Additionally, the tissue-derived PRS showed an increasing trend with the progression of gastric mucosal lesions. Conclusion:The tissue and plasma proteomics identified seven individual proteins that may indicate the risk of developing gastric cancer, showing the potential as biomarkers for aiding in the screening of gastric cancer.
5.Insight into the grading of breast phyllodes tumors
Yunfan WANG ; Xue ZONG ; Weicheng XUE
Chinese Journal of Pathology 2025;54(3):219-223
Phyllodes tumors (PT) of the breast is a rare fibroepithelial tumor, which can be divided into benign, borderline and malignant pathological types according to its histological characteristics. Malignant phyllodes tumor (MPT) accounts for 10%-20% of PT and has the ability of local recurrence and distant metastasis. Therefore, accurate diagnosis and identification of MPT are particularly important for patients to obtain appropriate treatment at the initial diagnosis. At present, histological morphology is the only diagnostic basis for MPT. However, due to the fact that phyllode tumor itself is a continuous disease spectrum with overlapping histological features, and the diagnostic classification adopts many histological parameters and their evaluation is subjective, pathologists lack consistency in MPT grading, and the biological behavior of PT is not completely consistent. Therefore, the existing MPT classification standards are facing challenges, and the accurate and reproducible classification is worthy of further exploration.
6.Insight into the grading of breast phyllodes tumors
Yunfan WANG ; Xue ZONG ; Weicheng XUE
Chinese Journal of Pathology 2025;54(3):219-223
Phyllodes tumors (PT) of the breast is a rare fibroepithelial tumor, which can be divided into benign, borderline and malignant pathological types according to its histological characteristics. Malignant phyllodes tumor (MPT) accounts for 10%-20% of PT and has the ability of local recurrence and distant metastasis. Therefore, accurate diagnosis and identification of MPT are particularly important for patients to obtain appropriate treatment at the initial diagnosis. At present, histological morphology is the only diagnostic basis for MPT. However, due to the fact that phyllode tumor itself is a continuous disease spectrum with overlapping histological features, and the diagnostic classification adopts many histological parameters and their evaluation is subjective, pathologists lack consistency in MPT grading, and the biological behavior of PT is not completely consistent. Therefore, the existing MPT classification standards are facing challenges, and the accurate and reproducible classification is worthy of further exploration.
7.Application of resting-state electroencephalography in assessment of upper limb motor function of stroke patients
Xinlei LI ; Wei WEI ; Jian SONG ; Yuqing ZHAO ; Weicheng KONG ; Jiayu CAI ; Haoran SHI ; Xiehua XUE
Chinese Journal of Rehabilitation Theory and Practice 2025;31(4):448-457
Objective To investigate the features of resting-state electroencephalography(EEG)in stroke patients with limited upper limb movement,and assess its potential utility in evaluating upper limb motor function.Methods From March to August,2024,a total of 71 stroke patients with limited upper limb movement were enrolled as stroke group at the Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine;while 63 healthy participants matched for age and sex were recruited as control group.They were tested with 19-chan-nel resting-state EEG(rsEEG),calculating of the pairwise derived brain symmetry index(pdBSI)and Delta/Al-pha ratio(DAR).The motor function was assessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),the upper limb recovery was evaluated with Brunnstrom Stages and the activities of daily living was assessed with modified Barthel index(MBI)in stroke patients,Results Compared with the control group,the pdBSI of Global lead,Frontal region,Central region and Posterior region across Delta,Alpha and Beta1 frequency bands were significantly higher in the stroke group than in the control group(|Z|>2.289,P<0.05);as well as the pdBSI of Global lead,Central region and Posterior region across The-ta bands(|Z|>3.016,P<0.01),the pdBSI of Global lead,Frontal region,Central region and Posterior region across Beta2 bands(|Z|>3.222,P<0.01),DAR of Global lead,Frontal region,Central region and Posterior re-gion(|Z|>6.565,P<0.001).In the stroke group,the pdBSI of Global lead(r=-0.280,P=0.018)and Central region(r=-0.304,P=0.010)across the Delta band were significantly negatively correlated with FMA-UE,as well as the pdBSI of Global leads(r=-0.289,P=0.014),Central region(r=-0.244,P=0.040)and Posterior region(r=-0.356,P=0.002)across the Beta1 band,and the DAR of Global lead(r=-0.431,P<0.001),Fron-tal region(r=-0.429,P<0.001),Central region(r=-0.491,P<0.001)and Posterior region(r=-0.482,P<0.001).Conclusion Asymmetry in spectral power between hemispheres in the Delta(0.5 to 4 Hz)and Beta(13 to 20 Hz)bands is found in stroke patients,especially in the central region,which correlates with upper limb function limitations.pdBSI Delta,pdBSI Beta1 and DAR are potential neuroelectrophysiological markers for assessing upper limb motor function in stroke patients.
8.Correct understanding of pathological evaluation and prognostic value of the invasion depth of early colorectal cancer (pT1)
Chinese Journal of Pathology 2025;54(11):1117-1123
Colorectal cancer (CRC) is one of the most malignant tumors with high morbidity and mortality worldwide. Early diagnosis and accurate pathological evaluation are of great significance for improving patient prognosis. Endoscopic resection is the main treatment for early CRC. Pathological parameters-such as margin status, lymphatic vascular invasion (LVI), tumor grade, depth of submucosal invasion and tumor budding are the key to determine whether curative resection is achieved. At present, the measurement method of submucosal invasion depth of pT1 CRC is controversial. Submucosal invasion depth measurement adopts different measurement methods for pedunculated and sessile lesions, mainly including measurement from the surface of the lesion or the lower edge of the mucosal muscle layer. Especially for sessile lesions, due to different observers different understandings of the position of the mucosal muscle layer that can be identified or evaluated in the guidelines, observers may apply different criteria to evaluate the integrity of the mucosal muscle layer. In recent years, more and more evidence has shown that the association between the depth of submucosal invasion and the risk of lymph node metastasis may be overestimated, while other pathological parameters (such as LVI, high-grade tumor budding, and poorly differentiated components) have equal or more important significance in prognostic stratification. Therefore, the current measurement of the depth of submucosal invasion of pT1 CRC and its prognostic value are facing challenges, which deserve our attention and further exploration.
9.Urine proteomics signatures associated with alcohol drinking among residents attending the National Upper Gastrointestinal Cancer Early Detection Program in Linqu, Shandong province
Hua FAN ; Xue LI ; Nairen ZHENG ; Sha HUANG ; Tong ZHOU ; Zhexuan LI ; Yang ZHANG ; Jingying ZHANG ; Weicheng YOU ; Kaifeng PAN ; Wenqing LI
Chinese Journal of Preventive Medicine 2021;55(9):1139-1144
The liquid chromatography tandem mass spectrometry was used to detect the urinary proteomics of 223 residents aged 40-69 years old who participated in the National Upper Gastrointestinal Cancer Early Detection Program in Linqu County, Shandong Province from November 22 to December 7, 2018, and analyze the alcohol consumption related proteomic profiles and individual urinary protein. There were significant differences in urinary protein profiles between alcohol consumption group and non-alcohol consumption group. The expression of 26 urinary proteins was up-regulated and 20 urinary proteins were down-regulated in alcohol consumption group ( P<0.05). The differentially expressed proteins had enzyme inhibitor activity and phospholipid binding function, and mainly enriched in pathways involving proximal tubule bicarbonate regeneration, complement and coagulation cascade, and cholesterol metabolism. The protein expressions of complement factor I (CFI), angiotensin converting enzyme 2 (ACE2) and protein C inhibitor (SERPINA5) were positively correlated with daily alcohol consumption.
10.Urine proteomics signatures associated with alcohol drinking among residents attending the National Upper Gastrointestinal Cancer Early Detection Program in Linqu, Shandong province
Hua FAN ; Xue LI ; Nairen ZHENG ; Sha HUANG ; Tong ZHOU ; Zhexuan LI ; Yang ZHANG ; Jingying ZHANG ; Weicheng YOU ; Kaifeng PAN ; Wenqing LI
Chinese Journal of Preventive Medicine 2021;55(9):1139-1144
The liquid chromatography tandem mass spectrometry was used to detect the urinary proteomics of 223 residents aged 40-69 years old who participated in the National Upper Gastrointestinal Cancer Early Detection Program in Linqu County, Shandong Province from November 22 to December 7, 2018, and analyze the alcohol consumption related proteomic profiles and individual urinary protein. There were significant differences in urinary protein profiles between alcohol consumption group and non-alcohol consumption group. The expression of 26 urinary proteins was up-regulated and 20 urinary proteins were down-regulated in alcohol consumption group ( P<0.05). The differentially expressed proteins had enzyme inhibitor activity and phospholipid binding function, and mainly enriched in pathways involving proximal tubule bicarbonate regeneration, complement and coagulation cascade, and cholesterol metabolism. The protein expressions of complement factor I (CFI), angiotensin converting enzyme 2 (ACE2) and protein C inhibitor (SERPINA5) were positively correlated with daily alcohol consumption.

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