Lung adenocarcinoma is prone to brain metastasis, and the prognosis of patients is extremely poor. The inhibitor of apoptosis-stimulating protein of p53 (iASPP) protein, encoded by the protein phosphatase 1 regulatory subunit 13-like (PPP1R13L) gene, is a key inhibitor of the p53 pathway and promotes carcinogenesis in various tumors, but its role in brain metastasis of lung adenocarcinoma is unknown. This study aims to analyze the tumor microenvironment characteristics of patients with brain metastasis of lung adenocarcinoma and explore the expression of PPP1R13L in brain metastasis tissues and its clinical significance by single-cell sequencing and clinical sample analysis.

To explore the genetic variants and phenotypic characteristics of patients with Neurofibromatosis type I (NF1).

Objective: To investigate the differences in clinicopathological and molecular characteristics between pure ovarian endometrioid carcinoma (POEC) and synchronous endometrial and ovarian endometrioid carcinoma (SEOEC), aiming to provide a basis for their differential diagnosis and individualized treatment. Methods: Clinical and pathological data were collected from ovarian endometrioid carcinoma patients and they were divided into POEC group (219 cases) and SEOEC group (169 cases) according to whether they had endometrioid endometrial carcinoma or not. Clinical data including the age at onset, reasons for medical consultation, maximum diameter of ovarian tumors and pathological examination results such as histologic grading of the lesions were collected. Additionally, follow-up outcomes and survival status of the patients were also recorded. Molecular subtyping results were obtained from 108 cases of POEC group and 109 cases of SEOEC group patients. Large-scale targeted sequencing using next-generation sequencing was performed on 76 POEC group samples (32 with matched peripheral blood) and 51 SEOEC group samples (46 with matched peripheral blood/normal tissue). The prognosis of POEC group and SEOEC group were analyzed. Moreover, SEOEC group were further stratified to high-risk group and low-risk group according to 2020 WHO classification of tumors and 2023 International Federation of Gynecology and Obstetrics (FIGO) staging of endometrial cancer. Results: (1) Clinicopathological characteristics: compared to the SEOEC group, POEC group patients exhibited the following characteristics: younger age at diagnosis (50.0 years vs 38.0 years, P<0.001), higher proportion presenting with typical ovarian cancer symptoms (45.7% vs 92.1%, P<0.001), higher detection rates of ovarian endometriosis (14.9% vs 56.2%, P<0.001) and uterine adenomyosis (23.0% vs 37.0%, P=0.021), higher proportion of low grade tumors (78.7% vs 95.4%, P<0.001), lower proportion of mismatch repair deficiency subtype (23.9% vs 3.7%, P<0.001). (2) Gene mutation profile: although the driver gene mutation profiles were similar between the two groups, POEC group patients had a significantly lower PTEN (22.4% vs 64.0%, P<0.001) and CTNNB1 (22.4% vs 48.0%, P=0.014) mutation rates compared to SEOEC group. Also, POEC group had a higher KRAS mutation rate than SEOEC group patients (50.0% vs 28.0%, P=0.055). (3)Prognosis: survival analysis revealed that POEC group patients had a significantly shater progression free survival time compared to the low-risk SEOEC group patients(P=0.046). However, their long-term survival outcomes (both overall survival and disease specific survival) were significantly better than those of the high-risk SEOEC group patients (P=0.018 and P=0.046, respectively). Conclusions: POEC and SEOEC represent two distinct tumor entities with significantly different clinical, pathological and molecular features. Accurate differential diagnosis is crucial for correct clinical decision-making.

Objective: To investigate dynamic positron emission tomography/magnetic resonance (dPET-MRI) using 18F-deoxyglucose (FDG) in distinguishing tumor progression (TP) from post treatment related change (PTRC) in patients with glioma. Methods: This study is a cross-sectional study. From July 2022 to September 2024, a total of 15 suspected recurrent/progressing post-treatment glioma patients were recruited at the Cancer Prevention and Treatment Center of Sun Yat sen University. They underwent 18F-FDG PET-MRI examination after postoperative radiotherapy in terms of static parameters, the SUVmax, SUVmean of all lesions and SUVmean of normal brain (gray matter and white matter) were measured. Additionally, target-to-background ratios (TBRgm and TBRwm) and SUV corrected for blood glucose (SUVgluc max and SUVgluc mean)were calculated. The two-tissue compartment model (2TCM) and Patlak plot were used to derive kinetic metrics, including K1, k2, k3, 2TCM-Ki, 2TCM-MRFDG, Patlak-Ki and Patlak-MRFDG. Receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic performance for differentiating TP from PTRC. Results: Fifteen patients, aged 48 (41, 54) years, including 5 males (33.3%), were detected on enhanced MRI images with a total of 18 lesions detected. Ultimately, 13 lesions were confirmed to have progressed. The 2TCM-Ki [0.018 (0.015, 0.022) vs 0.013 (0.012, 0.014), P=0.016], 2TCM-MRFDG [8.334 (7.041, 9.836) vs 6.281 (5.713, 7.469), P=0.046], Patlak-Ki [0.017 (0.014, 0.020) vs 0.010 (0.007, 0.011), P=0.004] and Patlak-MRFDG [7.742 (6.904, 9.084) vs 4.892 (3.833, 5.640), P=0.003] were significantly higher in TP than in PTRC. The Patlak-Ki values exhibited the high distinguishing performance with the area under the curve (AUC) of 0.954 (95%CI: 0.856-1.000), and the sensitivity and specificity was 92.3% and 100.0%, respectively. Conclusion: Kinetic metabolic parameters of 18F-FDG dPET-MRI, as a non-invasive biomarker, is hopeful as a non-invasive biomarker to distinguish TP from PTRC.

To investigate whether miR-100-5p regulates the proliferation and apoptosis of acute myeloid leukemia (AML) cells by targeting Tribbles pseudokinase 1 (TRIB1).

Objective: To explore a new classification method for adenocarcinoma of esophagogastric junction (AEG). Methods: This study consisted of an anatomical investigation and a retrospective case series. Twelve adult cadaveric specimens were included (8 males, 4 females), with a height of (166.9±11.7)cm (range:155 to 179 cm) and an age of (63.3±7.5) years (range: 56 to 72 years). Additionally, data from 20 patients who underwent radical three-incision total esophagectomy with proximal gastrectomy for middle/upper esophageal cancer at the Department of Gastrointestinal Surgery, Shanxi Provincial Cancer Hospital from March to June 2025 were analyzed (16 males, 4 females; aged (60.5±8.7) years(range: 50 to 71 years)). Pathological examination was performed on intact normal tissues from the esophagogastric junction. Results: Anatomical dissection revealed that the esophagogastric junction is a transitional structure with distinct anatomical landmarks and boundaries, enveloped by a unique sleeve-like membranous structure (Laimer's ligament), exhibiting specific histological features. Surgical specimens showed that the longitudinal veins of the lower esophagus branched gradually as they extended toward the stomach, forming a capillary network 1 to 2 cm above the dentate line before reconverging into thicker gastric mucosal veins approximately 1 cm below the dentate line. Histopathological examination further demonstrated that the transition from esophageal squamous epithelium to gastric columnar epithelium was not abrupt at the "Z-line" but exhibited overlapping, with gastric columnar epithelial cells migrating upward into the submucosa of the esophageal squamous epithelium for several millimeters. Based on anatomical findings and endoscopic landmarks, the Chinese classification of adenocarcinoma of esophagogastric junction (CHAEG) was proposed. Tumors were categorized into three types according to their origin: (1) CHAEG-E (perforator zone type): endoscopic tumor origin at the perforator zone; (2) CHAEG-P (palisade zone type): endoscopic tumor origin at the palisade zone; (3) CHAEG-G (gastric zone type): endoscopic tumor origin at the gastric zone. Each type was further subdivided into six subtypes based on the extent of tumor invasion at the upper and lower poles. Conclusions: This study preliminarily proposes a novel classification method for AEG, which may help resolve controversies regarding the extent of upper and distal resection margins and lymphadenectomy during radical surgery. However, the clinical value of this classification requires further investigation.

Objective: To investigate the effect of textbook oncologic outcome(TOO) on long-term survival and its related factors in patients with gastric cancer after operation. Methods: A retrospective cohort study was conducted to collect the clinicopathological data of 463 patients with gastric cancer who underwent radical surgery at the Department of General Surgery of Tianjin Medical University General Hospital from January 2019 to December 2021. There were 341 males and 122 females and the age was (65.7±9.2)years (range: 31 to 87 years).The patients were divided into TOO group(n=127) and non-TOO group(n=336) according to whether they met the TOO standard.Univariate analysis and multivariate Logistic regression model were used to analyze the independent factors affecting the realization of TOO. At the same time,the propensity matching analysis method was used to match the preoperative data of the patients. Kaplan-Meier method was used to compare the survival differences between the two groups after matching and draw the survival curve. Results: Among the 463 patients,127 patients (27.4%) achieved TOO while remaining 336 patients (72.6%) did not. Among them, 431 cases (93.1%) underwent lymph node dissection with ≥15 nodes, 449 cases (97.0%) received R0 resection, 346 cases (74.7%) had a hospital stay of <21 d, and 386 cases (83.3%) did not develop severe postoperative complications. Among the indicators that constitute TOO,the rate of completion of all cycles of chemotherapy in accordance with the guidelines after surgery was the lowest(30.5%, 141 cases). Univariate and multivariate analysis showed that age ≥65 years (OR=0.224,95%CI:0.137 to 0.367, P<0.01), postoperative ICU transfer (OR=0.599, 95%CI: 0.370 to 0.967, P=0.036), postoperative pathological nerve infiltration (OR=0.265, 95%CI: 0.085 to 0.827, P=0.022), and late pTNM stage (OR=0.113, 95%CI: 0.029 to 0.441, P=0.002) were the influencing factors of TOO. There was no difference in baseline data between the two groups after matching. The 1, 2, and 3-year overall survival rates of patients in the TOO group were 100%, 98%,and 95%,respectively. The 1,2,and 3-year overall survival rates of patients in the non-TOO group were 95%,90%,and 85%,respectively. Kaplan-Meier analysis showed that the difference in survival between the two groups was statistically significant(P=0.044). Conclusions: Gastric cancer patients with postoperative TOO have more significant survival benefits. Patients with age <65 years, not transferred to ICU,early pTNM stage and no nerve infiltration were more likely to achieve TOO. The textbook outcome of tumor can be used as a comprehensive index to evaluate the perioperative treatment and long-term prognosis of gastric cancer. Clinically,relevant management strategies should be actively optimized to improve the TOO achievement rate and improve the long-term survival outcome of patients.

Objective: To evaluate the efficacy of cytoreductive surgery (CRS) combined with tyrosine kinase inhibitor(TKI) for the treatment of recurrent and metastatic gastrointestinal stromal tumor(GIST) and to identify the prognostic factors. Methods: This is a retrospective cohort study. A total of 89 patients diagnosed with recurrent and/or metastatic GIST at the Department of General Surgery,the Sixth Affiliated Hospital of Sun Yat-sen University from December 2007 to August 2024 were included. Among them,67 were male and 22 were female,with an age of (56.0±11.9)years (range: 26 to 79 years). Patients were divided into two groups based on whether CRS was performed: the CRS combined with TKI therapy group (51 patients) and the TKI therapy alone group(38 patients). Clinical and pathological data,as well as prognostic data,were compared between groups using independent sample t-test,Wilcoxon rank-sum test, χ2 test,or Fisher's exact test. Cox proportional hazards regression model was used for prognostic factor analysis. Results: The CRS combined with TKI therapy group demonstrated superior median overall survival compared to the TKI therapy alone group (102.0 months vs. 65.5 months,P<0.05),with benefits remaining stable after inverse probability weighting (IPTW). For patients with newly diagnosed recurrence and/or metastasis,upfront CRS combined with imatinib showed improved progression-free survival(PFS) compared to imatinib alone (67.0 months vs. 24.0 months,P<0.05). However,following first-line imatinib failure,there was no significant difference in PFS between CRS combined with TKI therapy and TKI therapy alone (P=0.330). Among the 51 patients who underwent CRS,47 patients (74.6%) achieved complete cytoreduction (CC0/1). The incidence of Clavien-Dindo grade Ⅲ to Ⅳ complications was 17.5%(11/63),with no perioperative mortality. Survival analysis revealed that the CC0/1 group had superior median PFS time(22.0 months (95%CI: 18.0 to 67.0 months) vs. 13.0 months (95%CI: 3.0 months to not reached),P<0.01) and median overall survival time(not reached (95%CI: 85.6 months to not reached) vs. 31.5 months (95%CI: 25.1 months to not reached), P<0.01) compared to the CC2/3 group. Multivariate Cox analysis indicated that the completeness of cytoreduction was an independent prognostic factor for PFS (HR=5.804,95%CI: 1.841 to 18.296, P<0.01). Conclusion: CRS can improve the prognosis of patients with recurrent or metastatic GIST, especially at its initial diagnosis.

Objective: To evaluate the feasibility of linear cutting stapler-assisted en bloc lateral pelvic resection technique in pelvic exenteration (PE) for patients with locally advanced rectal cancer (LARC) or locally recurrent rectal cancer (LRRC) presenting with significant pelvic tumor mass effect and concurrent pelvic vascular invasion, and to summarize preliminary clinical experience. Methods: Indications for this surgical technique: (1) Preoperative imaging and pathological biopsy confirmed cT4b stage LARC or LRRC. (2) Preoperative contrast-enhanced pelvic MRI, contrast-enhanced pelvic CT, or CT angiography of iliac vessels confirmed significant lateral pelvic tumor invasion with obvious pelvic mass effect; the tumor invaded the lateral pelvic wall but did not penetrate the first layer, and no involvement of the common iliac or external iliac arteries and veins was noted. (3) Concurrent invasion of at least one branch of the anterior trunk, posterior trunk, or main trunk of the internal iliac vessels, requiring en bloc resection with the tumor. Contraindications: (1) Eastern Cooperative Oncology Group (ECOG) performance status score > 1 or Karnofsky Performance Status (KPS) score < 70; (2) Progressive distant metastases (e.g., liver, lung) or confirmed extensive intra-abdominal peritoneal dissemination during intraoperative exploration. Key steps of linear cutting stapler-assisted en bloc lateral pelvic resection: (1) The stapler cartridge and anvil were inserted into the lateral and medial spaces of the internal iliac vascular pedicle, respectively, to selectively divide the anterior trunk of the internal iliac artery alone or the anterior trunks of both internal iliac artery and vein simultaneously. (2) The distal stump was lifted, and blunt dissection was performed caudally along the surface of the lumbosacral trunk, sacral nerves, and piriformis fascia to dissect the loose lateral space of the internal iliac vascular pedicle to the vicinity of the sacral nerve roots. After freeing the lateral space beneath the piriformis fascia, the internal iliac vascular pedicle was en bloc elevated from the surface of the sacral nerves. The stapler cartridge and anvil were then inserted into the space on the surface of the sacral nerves and the medial space of the internal iliac vascular pedicle, respectively, and division was performed adjacent to the sacral bone surface to maximize lateral pelvic tissue resection. (3) The Marcille triangle approach (bounded by the lateral border of the L5 vertebra, the medial border of the iliopsoas muscle, and the cephalad aspect of the sacral promontory) was adopted. Dissection was performed distally along the common iliac vessels or proximally along the external iliac vessels to free and expose the roots of the common iliac, external iliac, and internal iliac vessels as well as their deep anatomical planes, along with the obturator nerve and lumbosacral trunk. (4) The root of the internal iliac artery was transected, and the common iliac vein and external iliac vein were suspended separately. The linear cutting stapler was inserted through the Marcille triangle to divide the root of the common iliac vein. (5) The internal pudendal vessels and inferior gluteal vessels were transected using the linear cutting stapler on the surface of the sacral nerves and piriformis muscle, medial to the ischial spine. If the pelvic floor muscles were elevated by incising the tendinous arch of the levator ani muscle, the linear cutting stapler could simultaneously divide the levator ani muscle, the lateral aspect of the levator ani muscle, and the recurrent internal pudendal vessels passing through the lesser sciatic foramen if necessary. Results: Between January 2023 and December 2024, 13 patients with LARC or LRRC and significant pelvic tumor mass effect underwent PE with linear cutting stapler-assisted en bloc lateral pelvic resection in the Department of Anorectal Surgery, The Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital). Among them, 10 were diagnosed with LARC and 3 with LRRC. The ratio of tumor diameter to pelvic diameter was 91.1% in the transverse plane (line connecting the bilateral ischial spines) and 90.9% in the sagittal plane (line connecting the L5-S1 interspace and the pubic bone). The mean time for lateral pelvic tumor resection was 49 (31-80) minutes, and the intraoperative blood loss was 900 (300-2 000) ml. The number of stapler cartridges used was (3.1±1.6), with a staple height of 1.5 (1.0-1.5) mm. R0 resection was achieved in 12 patients, and 6 patients developed severe complications of Clavien-Dindo classification ≥ grade III during the perioperative period. Conclusion: For LARC or LRRC patients with significant pelvic tumor mass effect and invasion of major lateral pelvic vessels, the application of linear cutting stapler-assisted en bloc lateral pelvic resection during PE may help shorten the operation time, reduce intraoperative blood loss, and decrease pelvic-related complications.

To investigate the clinicopathological characteristics of neuroendocrine(NE) cell dysplasia in gastric oxyntic gland mucosa. The clinical data of the patients with gastric mucosal NE cell dysplasia who underwent endoscopic submucosal dissection or endoscopic mucosal resection treatment at Xiangcheng County People's Hospital and the 989th Hospital of the Joint Logistics Support Force from January 2011 to October 2024 were retrospectively included. The clinical and endoscopic manifestations of the patients were analyzed, and their pathological morphological characteristics were observed in combination with immunohistochemical staining. A total of 15 patients were included, aged 54 years (32-69 years), including 6 males and 9 females. There were a total of 25 lesions (4 and 3 patients with 2 and 3 lesions, respectively) lincluding 21 lesions in the gastric body (84.0%) and 4 lesions in the gastric fundus (16.0%). Paris classification: 24 cases (96.0%) were classified as 0-Ⅱa type, 1 case (4.0%) as 0-Ⅱc type, with a median lesion diameter of 11.0 mm (2.0-36.0 mm). Narrowband imaging under endoscopy showed glandular duct disorder and abnormal blood vessels, and the mucosal features were consistent with autoimmune gastritis changes. Histological examination showed intrinsic glandular atrophy accompanied by intestinal metaplasia, and NE cells in mucosal hyperplasia presented as solid micro nodules (≤150 μm), arranged in a beam or glandular pattern. Enlarged micro nodules (>150 μm), fusion, sprout, and micro infiltration foci or single-cell infiltration can be seen, as well as nodules with newly formed stroma. It can be seen that the nodules are located within the mucosal muscle or above the lamina propria. Immunohistochemistry showed positive synaptic and chromaffin in NE cells, with nodules smaller than 0.5 mm in diameter and no submucosal infiltration. Sixteen (64.0%) cases of dysplasia lesions were accompanied by G1 grade neuroendocrine tumors, with continuous cell shape and unclear boundaries between the two. Gastric NE cell dysplasia is a precursor lesion of neuroendocrine tumors, and the key to diagnosis lies in identifying interstitial infiltration.

To develop and validate a machine learning-based multimodal radiomics model for predicting central lymph node metastasis (CLNM) in patients with clinically node-negative (cN0) papillary thyroid microcarcinoma (PTMC).

To investigate the regulatory role of lncRNA SNHG12 in docetaxel (DTX) resistance of prostate cancer (PCa) cells.

To analyze the expression pattern of Exoribonuclease Family Member 3 (ERI3) in hepatocellular carcinoma (HCC) tissues and its influences on long-term prognosis and cancer cell metastasis.

To evaluate the inhibitory effect of antitumor component-Ι in Agkistrodon halys venom (AHVAC-I) on proliferation and migration of cisplatin-resistant gastric cancer cells and explore the underlying mechanism.

The treatment of breast cancer with low expression of human epidermal growth factor receptor 2 (HER-2) has become a focused area in recent years. With the proved therapeutic effect of antibody-drug conjugates on breast cancer patients with HER-2-low expression, this subgroup has become a new targeting population in breast cancer. Recent studies have shown that patients with HER-2-ultralow breast cancer can also benefit from novel antibody-drug conjugates. To better standardize the rational clinical diagnosis and treatment of HER-2-low and HER-2-ultralow breast cancer, the Breast Cancer Professional Committee of China Anti-Cancer Association, along with Breast Cancer Prevention and Treatment Research Professional Committee of Maternal and Child Health Research Society of China reviewed the latest domestic and international clinical studies and important publications in recent years. Integrating the clinical experience of Chinese pathologists and oncologists, and following expert panel discussions, a consensus on the clinical diagnosis and treatment of HER-2-low and HER-2-ultralow breast cancer was developed. This consensus aims to deepen clinicians' understanding of HER-2-low and HER-2-ultralow breast cancer, promote more precise clinical decision-making, and ultimately improve patient survival and quality of life.

To investigate the clinicopathological characteristics and prognostic factors of cervical neuroendocrine carcinoma (NEC), and to clarify the independent prognostic value of the histological subtypes-mixed NEC (MiNEC) and pure NEC.

Objective G protein-coupled estrogen receptor 1 (GPER1) has been reported to exert tumor-suppressive effects in various malignancies. However, the mechanism by which GPER1 modulates macrophage M2 polarization via the myelocytomatosis oncogene (MYC) signaling pathway and its impact on gastric cancer (GC) progression remains poorly understood. This study aims to explore the role of the GPER1-MYC-interleukin 10 (IL-10) axis in GC. Methods Bioinformatic analyses were conducted to assess GPER1 expression levels and associated signaling pathways. AGS and HGC-27 gastric cancer cell lines with stable GPER1 overexpression or knockdown were generated, using normally cultured cells as controls. Cell proliferation, migration, and invasion were evaluated using the Cell Counting Kit-8 (CCK-8), wound healing, and TranswellTM assays, respectively. Western blotting was performed to examine MYC pathway activation, and the MYC-specific inhibitor 10058-F4 was used for mechanistic validation. A TranswellTM co-culture system was established to simulate tumor-macrophage interactions. Flow cytometry was used to quantify the proportion of M2 macrophages, and IL-10 secretion was measured via ELISA. Results GPER1 expression was significantly downregulated in GC tissues and showed a negative correlation with MYC signaling activity. Knockdown of GPER1 promoted malignant phenotypes in gastric cancer cells, whereas GPER1 overexpression exerted suppressive effects. Mechanistically, GPER1 inhibited M2 macrophage polarization and reduced GC cell proliferation, invasion, and migration by downregulating IL-10 expression via MYC suppression. Notably, the MYC inhibitor reversed the tumor-promoting effects induced by GPER1 knockdown and enhanced the antitumor effects of GPER1 overexpression. Conclusion GPER1 modulates macrophage M2 polarization through the MYC-IL-10 axis, thereby affecting gastric cancer progression. These findings indicate GPER1 as a potential therapeutic target for gastric cancer intervention.

To investigate the role of platelet-derived zyxin in promoting tumor migration by platelets.