Papillary thyroid carcinoma (PTC) can exhibit lateral neck lymph node metastasis at an early stage. Lateral neck lymph node metastasis is a crucial factor affecting the prognosis of PTC and is an absolute indication for neck lymph node dissection surgery. Additionally, it is a relative contraindication of endoscopic surgery for most medical centers. Therefore, the preoperative identification of lateral neck lymph node metastasis is vital for surgical decision-making and prognosis assessment. Ultrasound, CT, cytology, and clinical features can provide some information on lateral neck lymph node metastasis, but their accuracy does not fully meet clinical needs. Deep learning is a primary method for medical image recognition or feature extraction. In recent years, deep learning-based ultrasound, CT, cytology, conventional clinical parameters, or multimodal models combining these data have been developed and are expected to achieve routine clinical application. With the establishment and sharing of large datasets, automated annotation, algorithm optimization, and resolution of data security issues, deep learning is expected to accurately predict lateral neck lymph node metastasis in PTC. Furthermore, it can be integrated into electronic medical record systems for automated real-time analysis and assist clinical decision-making.

Linxian County in Henan Province, Northern China is known as the region with the highest incidence and mortality rate of esophageal cancer worldwide. Since 1959, the Henan medical team has conducted field work on esophageal cancer prevention and treatment in Linxian. Through three generations of effort exerted by oncologists over 65 years of research on esophageal cancer prevention and treatment in Linxian, the incidence rate of esophageal squamous cell carcinoma in this area has dropped by nearly 50%, and the 5-year survival rate has increased to 40%, reaching the international leading level. This article aims to summarize the history, present opportunities and new challenges, and explore the experience of esophageal cancer prevention and treatment in Linxian (referred to as the “Linxian experience”), providing reference and guidance to cancer prevention and treatment research in China.

[摘 要] 目的：探讨同源框蛋白C4（HOXC4）在胃癌组织和细胞中的表达及其对胃癌细胞增殖、迁移与侵袭的作用及其机制。方法：收集2020年5月至2021年4月期间在南阳市第一人民医院肿瘤科手术切除的16例进展期胃癌患者的癌及癌旁组织标本，以及人胃正常上皮细胞GES-1和胃癌细胞AGS、SGC-790和MGC-803，采用WB法检测胃癌组织和细胞中HOXC4的表达。通过RNA干扰技术对SGC-790及AGS细胞中HOXC4进行敲低或过表达，实验分为sh-HOXC4#1组、sh-HOXC4#2组、sh-Con组、sh-HOXC4 + pc-integrin β1组、pc-HOXC4组、pc-Con组、pc-HOXC4 + pc-integrin β1组。利用EdU、CCK-8、Transwell实验分别检测敲低或过表达HOXC4对各组细胞活力、增殖、侵袭、迁移和integrin β1表达的影响。用敲低HOXC4的胃癌AGS细胞构建荷瘤小鼠模型，观察敲低HOXC4对移植瘤体积及组织中Ki67和integrin β1蛋白表达的影响。结果：胃癌组织和细胞中HOXC4的表达均显著上调（均P < 0.01）。与sh-Con组相比，sh-HOXC4#1组和sh-HOXC4#2组SGC-790及AGS细胞中HOXC4、integrin β1蛋白表达水平，以及细胞的活力、增殖、迁移及侵袭能力均显著降低（均P < 0.01）。与sh-HOXC4组相比，sh-HOXC4 + pc-integrin β1组细胞活力、增殖、迁移及侵袭能力均显著增加（均P < 0.01）；与pc-Con组相比，pc-HOXC4组细胞活力、侵袭及迁移能力均显著增加（均P < 0.01）；与pc-HOXC4组相比，pc-HOXC4 + pc-integrin β1组细胞活力、迁移及侵袭能力均显著降低（均P < 0.01）。与sh-Con组相比，sh-HOXC4#1组和sh-HOXC4#2组小鼠移植瘤生长缓慢、体积变小，组织中Ki67和integrin β1表达均显著降低（均P < 0.01）。结论：HOXC4在胃癌组织与细胞中表达上调，其通过激活integrin β1信号促进胃癌细胞的增殖、迁移与侵袭。

Objective To investigate the effect of diosgenin on the proliferation and apoptosis of breast cancer cells and its potential molecular mechanism. Methods The breast cancer cell line MCF-7 was treated with low, medium, and high doses of diosgenin, and cell proliferation was detected through the MMT method. Flow cytometry was used to detect cell apoptosis. Nuclear-cytoplasmic-protein separation method was applied to detect the subcellular localization of death associated protein (DAXX). qRT-PCR and Western blot were used to detect the expressions of DAXX and c-Jun N-terminal kinase pathway (JNK)-related proteins. Results Diosgenin considerably inhibited the proliferation of MCF-7 cells and promoted cell apoptosis in a concentration-dependent manner. Diosgenin can promote the movement of DAXX from nucleus into the cytoplasm. Diosgenin upregulated the expression of cell surface death receptor (Fas), increased the phosphorylation levels of JNK and mitogen activated protein kinase (p38), and activated the JNK/p38 signaling pathway with concentration dependence. Conclusion Diosgenin inhibits the proliferation and promotes the apoptosis of the breast cancer cell line MCF-7, whose mechanism may be related to the regulation of DAXX subcellular localization and the activation of JNK/p38 signaling pathway.

Objective To analyze the correlation of mean corpuscular volume (MCV) with clinical features and the prognosis of patients with treatment-related acute myeloid leukemia (t-AML). Methods The clinical and laboratory data of 41 patients with t-AML were retrospectively analyzed. The patients were divided into LMCV and HMCV groups. Spearman’s rank correlation was used for correlation analysis, and a survival curve was drawn via Kaplan-Meier method. Log-rank test was used for comparison between groups, and Cox proportional risk regression model was used for multivariate analysis. Results The treatment history of G-CSF was positively correlated with the MCV of patients with t-AML (correlation coefficient r=0.325, P<0.05). The amount of RBC and HGB in the peripheral blood of patients and the percentage of PML-RARa positive in the LMCV group were significantly higher than those in the HMCV group, and the percentages of the expression levels of lymphoid antigen CD7 and CD56 were significantly lower than those in the HMCV group (P<0.05). The therapeutic effect, OS, and RFS of the LMCV group were better than those of the HMCV group (P<0.05). Failure to reach CR was an independent risk factor for OS of patients with t-AML (HR=0.053, P=0.002), and MCV≥98.9 fl was an adverse factor for OS and RFS of patients with t-AML (P<0.1) but not an independent risk factor (P>0.05). Conclusion Patients with t-AML with different levels of MCV have different clinical characteristics, and patients with high MCV have poor therapeutic effect and prognosis.

Objective To investigate the screening results and factors affecting abnormal detection rates among high-risk groups of esophageal cancer and to explore effective intervention measures. Methods We investigated and collected the information on gender, education level, age, marital status, symptoms of reflux esophagitis (heartburn, acid reflux, belching, hiccup, foreign body sensation in the pharynx, and difficulty swallowing), consumption of pickled vegetables, salt use, and esophageal cancer incidence of villagers in a natural village in Wenfeng District, Anyang City, Henan Province. Changes in reflux esophagitis symptoms in the high-incidence area of esophageal cancer before and after 16 years were observed, and the relationship of such changes with esophageal cancer was analyzed. Results In 2008, 711 cases were epidemiologically investigated, including 213 cases with one of the symptoms of reflux esophagitis such as heartburn, acid reflux, belching, hiccups, foreign body sensation in the pharynx, and difficulty swallowing (sorted in accordance with the abovementioned symptoms; if there are multiple symptoms, then the former is taken); 55 cases with at least two related symptoms, among which the most symptom was heartburn in 108 cases (15.1%); followed by acid reflux, belching, etc. In 2024, the same group of people was investigated, and eight people were missing because of relocation. A total of 703 people were successfully investigated, of which 189 cases (26.8%) had one of the symptoms of reflux esophagitis, such as heartburn (sorted in accordance with relevant symptoms, if there are multiple symptoms, then the former will be selected); 167 cases (23.7%) had at least two related symptoms, among which the most symptom was heartburn in 139 cases (19.7%); followed by acid reflux. Over 16 years, among the 703 people investigated, 45 cases had esophageal cancer and they had one or more of the abovementioned symptoms. No significant differences in the reflux esophagitis-like symptoms were found between 2008 and 2024 (P=0.26); no significant differences in the composition of reflux esophagitis-like symptoms were found between 2008 and 2024 (P=0.299). Conclusion The detection rate of reflux esophagitis-related symptoms in the population in a high-risk area of esophageal cancer has not decreased in the past 16 years, and the high-risk factors still exist. Esophageal cancer is closely related to reflux esophagitis, and clinical practice can provide early diagnosis and treatment for high-risk population.

Objective To investigate the relationship between tooth loss and the occurrence of esophageal cancer in a natural village in Wenfeng District, Anyang City, Henan Province. Methods A prospective cohort study was conducted to observe the occurrence of tooth loss and esophageal cancer among the asymptomatic residents of the natural village for 16 years from January 2008 to July 2024. Data were analyzed by chi-square test, binary logistic regression, and restricted cubic spline. Results Among the total population of 711 cases, 136 cases were lost to follow-up and 575 cases were included in the final statistics, including 45 cases with esophageal cancer. Significant statistical difference was found between esophageal cancer patients with and without tooth loss (P<0.05). Logistic regression analysis showed that tooth loss was associated with the occurrence of esophageal cancer (OR=3.977, 95%CI: 1.543-10.255). After the adjustment for confounders, tooth loss remained significantly associated with the occurrence of esophageal cancer (OR=3.038, 95%CI: 1.035-8.914). A nonlinear dose-response relationship was observed between the number of teeth lost and the incidence of esophageal cancer. When the number of teeth lost was less than 12, the risk of esophageal cancer increased with the number of teeth lost. When more than 12 teeth were lost, the risk of esophageal cancer decreased as the number of teeth lost increased. Conclusion Tooth loss is a risk factor for the occurrence of esophageal cancer in this natural village. When the number of teeth lost is less than 12, the risk of esophageal cancer increases with the number of teeth lost.

Objective To understand the disease spectrum of a natural village in an area with high incidence of esophageal cancer to provide a reference for precise prevention and control. Methods From 2008 to 2024, 711 asymptomatic people over the age of 35 years in a natural village with high incidence of esophageal cancer in China were surveyed, and 171 of them were subjected to gastroscopy, biopsy, and pathological examination. All participants were followed up for a long time, and their disease history was recorded. Results A total of 16 years of follow-up were performed, and 703 people were effectively followed up. In 2008, 171 people underwent gastroscopy, and 160 people had biopsy and pathological results in endoscopic screening. By 2024, 76 people had been diagnosed with malignant tumors of 12 different types, and among these people, 45 had esophageal cancer. Conclusion Esophageal cancer remains a significant cause of morbidity and mortality from malignant tumors in this region. Biopsy and pathological examination should be strengthened during gastroscopy, and follow-ups and regular check-ups should be given high importance to reduce the incidence and mortality rates of esophageal cancer.

Objective To investigatethe relationship between gastroesophageal reflux disease (GERD) symptoms and clinicopathological characteristics, p53 expression, and survival of Chinese patients with esophageal adenocarcinoma. Methods A total of 3882 patients with esophageal adenocarcinoma, 970 matched patients with esophageal squamous cell carcinoma, and 970 matched patients with gastric cardia adenocarcinoma were included to compare the incidence of GERD symptoms. Patients with esophageal adenocarcinoma were divided into two groups according to the presence and absence of GERD symptoms. The differences in clinicopathological characteristics and p53 expression between the two groups were compared by chi-square test, and the differences in survival between the two groups were compared by landmark analysis. Results The incidence of GERD symptoms increased successively in esophageal squamous cell carcinoma, esophageal adenocarcinoma, and gastric cardia adenocarcinoma. In patients with esophageal adenocarcinoma, the proportions of male, less than 65 years old, lower thoracic tumors, tumors without squamous cell carcinoma, poorly differentiation, early tumors (stage 0-I), and p53-positive tumors in the group with GERD symptoms were higher than those in the group without GERD symptoms; moreover, the long-term survival (≥15 years) was better. Conclusion GERD symptom is an important clinical sign of esophageal adenocarcinoma. It is closely related to specific clinicopathological characteristics, p53 overexpression, and good long-term prognosis.

Objective To investigate the effects of crocetin on radiosensitivity of lung adenocarcinoma and its potential mechanisms using a nude mouse xenograft model established with A549 lung adenocarcinoma cells. Methods Forty mice bearing lung adenocarcinoma were randomly divided into four groups: control group, crocetin group, radiotherapy group, and crocetin combined with radiotherapy group, and received the corresponding interventions. After 14 days of treatment, all mice were sacrificed and tumor tissues were excised. Tumor weight was measured in each group and the tumor inhibition rate was calculated. Apoptosis of tumor cells was analyzed by flow cytometry. Immunohistochemistry and RT-qPCR were used to detect and compare the expression of genes encoding hypoxia-inducible factor (HIF-1α) and B-cell lymphoma-2 (BCL-2). Results The mean tumor weight of mice in the crocetin combined with radiotherapy group was significantly lower than that in the radiotherapy group (P < 0.05), and the tumor inhibition rate of the crocetin combined with radiotherapy group was 34.07%. The mean tumor cell apoptosis rate in the crocetin combined with radiotherapy group was significantly higher than that in the radiotherapy group (P < 0.05). HIF-1α expression was significantly lower in the crocetin combined with radiotherapy group than in the radiotherapy group (P = 0.001). Although BCL-2 expression in the crocetin combined with radiotherapy group was lower than that in the radiotherapy group, the difference was not statistically significant (P = 0.894). The expression levels of mRNAs of genes encoding HIF-1α and BCL-2 in the crocetin combined with radiotherapy group were significantly lower than those in the radiotherapy group (P < 0.05). Conclusion Crocetin in combination with radiotherapy significantly enhanced the inhibitory effect of radiotherapy on tumor growth in mice bearing lung adenocarcinoma and increased the tumor inhibition rate. The mechanisms may involve the alleviation of radiotherapy-induced overexpression of HIF-1α, thereby improving hypoxic conditions in tumor tissues, as well as suppression of the anti-apoptotic gene BCL-2 to enhance radiotherapy-induced apoptosis of lung adenocarcinoma cells.