Malignant Tumors In China Research Articles

From Conversion to Resection for Unresectable Hepatocellular Carcinoma: A Review of the Latest Strategies.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in China, accounting for the majority of primary liver cancer cases. Liver resection is the preferred curative method for early-stage HCC. However, up to 80-85% of patients have already missed the opportunity of radical surgery due to tumor advances at the time of consultation. Conversion therapies are a series of medications and treatments for initially inoperable patients. For early-stage unresectable HCC (uHCC) patients, conversion therapies are designed to meet surgical requirements by increasing the volume of the residual liver. Meanwhile, for advanced cases, conversion therapies strive for tumor shrinkage and down-staging, creating the opportunity for liver resection or liver transplantation. This review summarizes the latest advances in conversion therapies and highlights their potential for improving the survival benefit of patients with uHCC.

Current Perspectives of Immunotherapy for Hepatocellular Carcinoma.

Hepatocellular carcinoma is the sixth most common tumor and the third leading cause of cancer death worldwide. It ranks fourth in the spectrum of malignant tumor incidence and second in the order of death from major malignant tumors in China. Hepatocellular carcinoma is a complex ecosystem containing non-tumor cells (mainly immune-related cells), and its immunotherapy can stimulate the recognition of specific tumor antigens, inhibit the proliferation of cancer cells, and produce over-memory lymphocytes, which can prevent recurrence. So, immunotherapy of hepatocellular carcinoma is increasingly becoming a research hotspot in liver cancer treatment. With the intensive research in recent years, great progress has been made in immunotherapy for hepatocellular carcinoma, including immune checkpoint inhibitors, pericyte therapy, vaccination, and antiviral therapy. In addition, the study found that the therapeutic effect of combination therapy was enhanced compared to monotherapy. This review summarizes the most prominent immunotherapies currently available for the clinical treatment of patients with HCC and the main opportunities and challenges facing HCC research.

China clinical practice guideline for epidermal growth factor receptor tyrosine kinase inhibitors in stage Ⅳ non-small cell lung cancer (version 2023)

The incidence and mortality of lung cancer rank first among malignant tumors in China. Among them, non-small cell lung cancer (NSCLC) is the most important pathological type, accounting for 80%-85% of lung cancer patients, including adenocarcinoma, squamous cell carcinoma and other pathological subtypes. In recent years, with the discovery of epidermal growth factor receptor (EGFR) gene and the successful development of tyrosine kinase inhibitors (TKIs), the treatment efficacy of stage Ⅳ NSCLC patients with EGFR gene sensitive mutation has been greatly improved. As of August 23, 2023, the first generation EGFR-TKIs, gefitinib, icotinib, and erlotinib; the second generation EGFR-TKIs, afatinib and dacomitinib; and the third generation EGFR-TKIs, osimertinib, almonertinib, furmonertinib and befotertinib were all approved for marketing by China National Medical Products Administration (NMPA). In addition, multiple domestic third-generation EGFR-TKIs are undergoing clinical trials, such as rezivertinib (BPI-7711), limertinib (ASK120067), and oritinib (SH-1028). Meanwhile, mobocertinib and sunvozertinib, which targets EGFR 20ins mutations, were also approved by NMPA. With the increasing variety of EGFR-TKIs approved for marketing subsequently, it brings confusion to clinicians when choosing specific medications, and there is an urgent need to develop relevant treatment guidelines. Hence, the Medical Oncology Branch of China International Exchange and Promotive Association for Medical and Health Care and the Chinese Association for Clinical Oncologists convened experts to integrate the research results of various EGFR-TKIs, and proposed the "China clinical practice guideline for epidermal growth factor receptor tyrosine kinase inhibitors in stage Ⅳ non-small cell lung cancer (version 2023)", to provide reference for better clinical practice.

A Review of Advances in the Surgical Treatment of Coronary Heart Disease and Lung Cancer.

Lung cancer is currently the most prevalent and fatal malignant tumor in China. Additionally, the incidence of coronary heart disease is steadily increasing. Both diseases exhibit a higher risk of mortality with age, particularly among elderly patients. Moreover, these diseases are interconnected and share common risk factors. However, the treatment options for patients suffering from both lung cancer and coronary heart disease lack clarity and standardized criteria. This article critically examines the literature on surgical interventions for patients with lung cancer complicated by coronary artery disease during the period from January 2021 to December 2022. It summarizes the safety and effectiveness of these interventions and highlights the various surgical options available for different patient profiles.

Advances in Neoadjuvant Immunotherapy for Locally Advanced Esophageal Cancer

Abstract: Esophageal cancer is one of the common malignant tumors in China with a high mortality rate. Neoadjuvant chemoradiotherapy (nRCT) is currently the primary treatment method for locally advanced esophageal cancer. However, nRCT has not been not widely applied in China due to several reasons. First, the radiotherapy equipment and technology vary in different regions, and the learning curve for these technologies is steep, making rapid implementation difficult. Furthermore, the combined toxicity of radiotherapy and chemotherapy can counteract the survival benefits of preoperative treatment. In recent years, a promising approach involves combining neoadjuvant chemotherapy with immunotherapy for patients with locally advanced esophageal cancer. This article offers an overview of the progress in neoadjuvant therapy for this condition.

Clinical significance of serum oxidative stress and serum uric acid levels before surgery for hepatitis B-related liver cancer.

The incidence and mortality of liver cancer are among the highest of all malignant tumors in China. The high recurrence rate after conventional hepatectomy is worrying. There is a lack of effective prognostic indicators for liver cancer. To explore the clinical significance of preoperative serum oxidative stress and serum uric acid (UA) levels in hepatitis B-related liver cancer. The medical records of 110 hepatitis B-related liver cancer patients who underwent hepatectomy in Gansu Provincial Hospital were retrospectively analyzed. Recurrence in patients within 3 years after surgery was determined. The logistic regression model and Pearson or Spearman correlation were used to analyze the correlation between oxidative stress level and UA, and the recurrence of hepatitis B-related liver cancer. Compared with the non-recurrence group, the levels of superoxide dismutase (SOD) and glutathione (GSH) in the recurrence group were lower and the levels of malondialdehyde (MDA) and UA were higher (all P < 0.05). UA, SOD, MDA, and GSH were risk factors for postoperative recurrence in hepatitis B-related liver cancer patients (P < 0.05). UA was positively correlated with MDA (r = 0.395, P < 0.001) and negatively correlated with GSH (r = -0.204, P = 0.032). The area under the receiver operating characteristic curve (AUC) of SOD, MDA, GSH, and UA in predicting the prognosis was 0.276, 0.910, 0.199, and 0.784, respectively (all P < 0.001). The preoperative serum SOD, GSH, MDA, and UA levels had significant predictive effects on postoperative recurrence of hepatitis B-related liver cancer.

Exploring the Role of DKK1 in the Occurrence of Lung Adenocarcinoma Based on the Analysis of Bioinformatics

Lung cancer is the most common malignant tumor in China, lung adenocarcinoma (LUAD) is the main type of lung cancer, which is a serious threat to people's life and health. At present, there are fewer studies on the role of Dikkopf1 (DKK1) in lung adenocarcinoma. The aim of this study was to investigate the role and potential prognostic value of DKK1 in the development of lung adenocarcinoma by bioinformatics methods. Several databases, such as genotype-tissue expression (GTEx), The Cancer Genome Atlas (TCGA) and tumor-immune system interactions database (TISIDB), were used to analyze the expression, clinicopathological features, immune cell infiltration, prognosis and methylation of DKK1 in lung adenocarcinoma. Then, linked immune cell infiltration Omics database was used to analyze the co-expressed genes of DKK1 and their functional enrichment. Finally, 59 pathological samples of paraffin-embedded lung adenocarcinoma patients who underwent surgery at the Affiliated Cancer Hospital of Xinjiang Medical University between 2016 and 2017 were collected for the validation of the prognostic value of expression by immunohistochemistry (IHC) test. The results of bioconfidence analysis showed that the expression level of DKK1 in lung adenocarcinoma tissues was higher than that in normal tissues, the expression in advanced cancers was higher than that in early stages, and the experimental validation revealed that among 59 cases of lung adenocarcinoma, there were 15 cases of negative expression (25.4%), 18 cases of weakly positive expression (30.5%), and 26 cases of strongly positive expression (44.1%). The different expression of DKK1 is related to methylation, prognosis and the activities of various immune cells. Functional enrichment shows that DKK1 may be involved in skin development and cell-substrate junction, and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis shows that DKK1 is related to ABC transporters. Bioinformatics analysis and clinical case specimens showed that high DKK1 expression was associated with poorer prognosis in patients with lung adenocarcinoma. High expression of DKK1 in lung adenocarcinoma is associated with poor prognosis. DKK1 is closely associated with tumor immune cell infiltration and pathways. DKK1 can be considered as a potential prognostic marker and a novel target for immunotherapy of lung adenocarcinoma.

Natural Products Treat Colorectal Cancer by Regulating miRNA.

Diseases are evolving as living standards continue to improve. Cancer is the main cause of death and a major public health problem that seriously threatens human life. Colorectal cancer is one of the top ten most common malignant tumors in China, ranking second after gastric cancer among gastrointestinal malignant tumors, and its incidence rate is increasing dramatically each year due to changes in the dietary habits and lifestyle of the world's population. Although conventional therapies, such as surgery, chemotherapy, and radiotherapy, have profoundly impacted the treatment of colorectal cancer (CRC), drug resistance and toxicity remain substantial challenges. Natural products, such as dietary therapeutic agents, are considered the safest alternative for treating CRC. In addition, there is substantial evidence that natural products can induce apoptosis, inhibit cell cycle arrest, and reduce the invasion and migration of colon cancer cells by targeting and regulating the expression and function of miRNAs. Here, we summarize the recent research findings on the miRNA-regulation-based antitumor mechanisms of various active ingredients in natural products, highlighting how natural products target miRNA regulation in colon cancer prevention and treatment. The application of natural drug delivery systems and predictive disease biomarkers in cancer prevention and treatment is also discussed. Such approaches will contribute to the discovery of new regulatory mechanisms associated with disease pathways and provide a new theoretical basis for developing novel colon cancer drugs and compounds and identifying new therapeutic targets.

Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer (2023 edition)

Colorectal cancer is one of the most common malignant tumors in China. In recent years, the incidence and mortality of colorectal cancer in China has been on the rise. According to the China Cancer Statistics Report in 2020, the incidence and mortality of colorectal cancer in China ranked second and fifth among all malignant tumors, with 555, 000 new cases and 286, 000 deaths. China has become the country with the highest number of new cases and deaths of colorectal cancer every year in the world, which seriously threatens the health of Chinese residents. In 2010, the National Ministry of Health organized the colorectal cancer expertise of the Chinese Medical Association to write the Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer (2010 edition) and publish it publicly. Since 2010, the National Health and Family Planning Commission has organized experts to revise the protocol in 2015 and 2017, while the National Health Commission revised it in 2020 and 2023. The revised part of the Chinese Protocol of Diagnosis and Treatment of Colorectal Cancer (2023 edition) involves new progress in the field of imaging examination, pathological evaluation, surgery, chemotherapy and radiotherapy. The 2023 edition of the protocol not only referred to the contents of the international guidelines, but also combined with specific national conditions and clinical practice in China, and also included many evidence-based clinical data recently in China. The 2023 edition of the protocol would further promote the standardization of the diagnosis and treatment of colorectal cancer in China, improve the survival and prognosis of patients, and benefit millions of patients with colorectal cancer and their families.

Progress of PD-1/PD-L1 signaling in immune response to liver transplantation for hepatocellular carcinoma.

Primary liver cancer is one of the most common malignant tumors in China. The vast majority of primary liver cancer are hepatocellular carcinoma. Due to its high incidence and mortality from HCC, HCC has always been a feared type of cancer. Liver transplantation, as one of the important means to treat advanced liver cancer, has brought new hope to patients. However, as patients have been in a state of immunosuppression after liver transplantation, these patients face new problems of HCC recurrence and metastasis. A increasing number of studies have proved that blocking the PD-1/PD-L1 signaling pathway and restoring the immune killing inhibition of T cells can produce better therapeutic effects on tumors and chronic infectious diseases. As a promising treatment in the field of tumor immunotherapy, PD-1/PD-L1 inhibitors have achieved important results in liver cancer patients, but their application in liver transplantation patients is still highly controversial. This paper will introduce the mechanism of action of PD-1/PD-L1 signaling pathway and the current basic and clinical studies of PD-1/PD-L1 signaling pathway associated with immune response in HCC transplantation.

The prospect and challenge of liquid biopsy in the diagnosis and treatment of chest malignancy

In recent years, the incidence of chest malignant tumors in China has increased year by year, which has seriously threatened the health problems of people. Among them, early screening and intervention of patients with chest malignancies is the key to cancer prevention. Early detection, early diagnosis, and early treatment as the "three early prevention" of clinical practice are conducive to improve the survival rate of tumor patients. As a non-invasive and real-time reflection of tumor status, liquid biopsy has gradually received attention in clinical diagnosis and treatment. Circulating tumor cells (CTCs), circulating tumor DNA (ctDNA) and exosomes as liquid biopsy "Three carriages" are not only widely used in the diagnosis, monitoring and prognostic evaluation of chest malignancies, but also face many unknown challenges. In this article, the application of liquid biopsy in chest malignancies in recent years is elaborated in detail, which provides a reference for the formulation of clinical tumor prevention and diagnosis and treatment strategies.

Psychological and reproductive decision-making experiences of young women after breast cancer diagnosis: a qualitative study

BackgroundBreast cancer has the highest incidence rate among malignant tumors in China, with a trend of affecting younger women. The treatment has short- and long-term adverse effects such as damage to the ovaries, which may result in infertility. Such consequences then increase patients’ concerns over future reproduction. At present, nor do medical staffs continuously assess their overall well-being, or ensure that they have the knowledge necessary to manage their reproductive concerns. This qualitative study aimed to explore psychological and reproductive decision-making experiences of young women who had experienced childbirth after their diagnosis.MethodsThe phenomenological research, as a kind of qualitative study, was conducted on 12 young women who experienced childbirth after breast cancer diagnosis. Data collection was from September 2021 to January 2022 and content analysis method was used to analyze the data.ResultsFive main themes were identified: (1) desire for childbearing from individual, familial, and social aspects after the diagnosis of breast cancer; (2) emotional experiences through pregnancy till raising children; (3) support needs from professionals, family, and peer; (4) self and doctors’ influencing factors on reproductive decision-making; and (5) satisfaction with the outcome of reproductive decision-making.ConclusionsThe desire for childbearing of young women should be considered during the reproductive decision-making process. A multidisciplinary team is suggested to be set up to provide professional support. During the reproductive process, professional and peer support should be strengthened to improve decision-making abilities, alleviate negative emotional experience, and smoothen the process of reproductive experience for young patients.

Construction of DNA methylation-based biomarkers for diagnosis of hepatocellular carcinoma.

3048 Background: Hepatocellular carcinoma is the most common malignant tumor in China. Most of the patients are found in the advanced stage, which causes its low survival rate. According to the latest epidemiological data, hepatocellular carcinoma is the second leading cause of cancer mortality. DNA methylation is closely related to tumor development. In this study, differentially expressed methylated genes related to tumorigenesis and development were screened from the database and the diagnostic model was constructed for early screening. Methods: Limma package was used to analyze the differences between TCGA _ LIHC liver cancer and GSE113409 normal blood methylation sites and differentially expressed methylation sites (logFC&gt;1，p&lt;0.05) were identified. The TCGA _ LIHC methylation database was used as the training set. Lasso method, and random forest method were used for screening the differentially expressed methylation sites for the construction of the diagnostic model. After that, the characteristic coefficient of methylation sites and ROC curve of the diagnostic model were obtained from the training set. According to the cd-score, HCC patients could be diagnosed in the early stage, thus improved their survival. Results: Limma package was used to analyze the differences between TCGA _ LIHC liver cancer and GSE113409 normal blood methylation sites and 7109 differentially expressed methylation sites (logFC&gt;1，p&lt;0.05) were identified. Then the top 1000 differentially expressed methylation sites were selected. The TCGA _ LIHC methylation database was used as the training set. 30 methylation sites were screened by lasso method, and 20 methylation sites were screened by random forest. Taking the intersection, a total of 6 methylation sites were obtained for diagnostic model: cg00346208, cg00084798, cg00458878, cg00006397, cg00325910, cg00399027. The characteristic coefficient of methylation sites were displayed in the table below and the AUC of the diagnostic model was 0.9991579. High cd-score tended to have hepatocellular carcinoma, and vice versa. Conclusions: We have identified several DNA methylation markers for the diagnosis of hepatocellular carcinoma from GEO and TCGA databases. This model can predict hepatocellular carcinoma and the AUC is higher than that of AFP, which means it may become a more sensitive indicator for the diagnosis of liver cancer. [Table: see text]

PDMS-TiO2 composite films combined with LC-MS/MS for determination of phospholipids of urine in non-small cell lung cancer patients with traditional Chinese medicine syndromes

Lung cancer is one of the most common malignant tumors in China. Most patients are already in the mid to advanced stages during the consultation and the survival rate is less than 23 % with a poor prognosis. Therefore, effective dialectical diagnosis of advanced cancer can guide individualized treatment to improve survival. Phospholipids are the building blocks of cell membranes and abnormal phospholipid metabolism is associated with plentiful diseases. Most studies of disease markers use blood as a sample. However, urine covers extensive metabolites that are produced during the body's metabolic processes. Therefore, the study of markers in urine can be used as a complement to improve the diagnosis rate of marker diseases. Moreover, urine is characterized by high water content, high polarity, and high inorganic salt, therefore the detection of phospholipids in urine is challenging. In this study, an original Polydimethylsiloxane (PDMS)-titanium dioxide (TiO2) composite film for sample pre-treatment coupled with the LC-MS/MS method for the determination of phospholipids in the urine with high selectivity and low matrix effects was prepared and developed. The extraction process was scientifically optimized by the single-factor test. After systematic validation, the established method was successfully applied to the accurate determination of phospholipid substances in the urine of lung cancer patients and healthy subjects. In conclusion, the developed method has great potential for the development of lipid enrichment analysis in urine and can be used as a beneficial tool for cancer diagnosis and Chinese medicine syndrome typing.

Selection of Therapeutic Strategies after Preoperative Neoadjuvant Chemoradiotherapy for Rectal Cancer

Rectal cancer is one of the most common malignant tumors in China, which is mainly middle and low rectal cancer. Due to the particularity of the physiological and anatomical location of the rectum and the neglect of the relevant clinical symptoms, patients with rectal cancer in real life often have the local progression stage. A large number of studies have shown that neoadjuvant chemoradiotherapy should be performed in such patients, to achieve tumor downstaging before rectal cancer surgery. In this study, different treatment measures for rectal cancer patients after neoadjuvant chemoradiotherapy are presented.

Extent of lymphadenectomy for esophageal cancer

Esophageal cancer is a common malignant tumor in China. For resectable ones, surgery is still the primary treatment. At present, the extent of lymph node dissection remains controversial. Extended lymphadenectomy makes metastatic lymph nodes more likely to be resected, which contributed to pathological staging and postoperative treatment. However,it may also increase the risk of postoperative complications and affect prognosis. Therefore, it is controversial how to balance the optimal extent/number of dissected lymph nodes for radical resection with the lower risk of severe complications. In addition, whether the lymph node dissection strategy should be modified after neoadjuvant therapy needs to be investigated, especially for patients who have a complete response to neoadjuvant therapy. Herein, we summarize the clinical experience on the extent of lymph node dissection in China and worldwide, aiming to provide guidence for the extent of lymph node dissection in esophageal cancer.

Cluster Analysis of Cancer Incidence among Smoking Men in China

In recent years, the incidence rate and mortality of lung cancer have shown a rapid growth trend, and its pathogenic factors have also attracted widespread attention. At present, it is universally acknowledged that smoking has a strong correlation with lung cancer. Statistics show that 80% of lung cancer patients have smoking history. At the same time, it is also pointed out that quitting smoking in normal people can change the composition of intestinal flora; And in the normal population and patients with inflammatory bowel disease, the composition of intestinal flora between smokers and non-smokers is different. But now, in colorectal adenoma and colorectal cancer patients, the impact of smoking on intestinal flora is still unclear. To sum up, this topic plans to further study the relationship between smoking, intestinal flora and colorectal tumors. Cluster analysis was used to comprehensively evaluate and classify the incidence data of malignant tumors in 32 tumor registries in China, so as to further understand the regional distribution characteristics of malignant tumors in China. The results showed that compared with normal healthy people, the composition of intestinal flora in patients with colorectal cancer was different, and smoking could also change the intestinal flora. However, whether intestinal flora plays a role in promoting the occurrence and development of colorectal cancer by smoking needs further study.

Research progress in cuproptosis in liver cancer.

Copper, like iron, is an essential trace metal element for human cells. The role of iron overload and ferroptosis has been gradually clarified in tumors, but the role of copper overload and cuproptosis is still being explored. Cuproptosis is a novel mode of cell death, secondary to impaired mitochondrial function induced by copper overload, and characterized by copper-dependent and programmed. The excessive copper leads to protein toxicity stress by binding to sulfhydryl proteins in the tricarboxylic acid (TCA) cycle of mitochondria, disrupting cellular homeostasis and triggering cuproptosis. Copper accumulation has carcinogenic effects on normal cells, dual effects on tumor cells. Liver cancer is one of the most common malignant tumors in China and even globally, with hepatocellular carcinoma (HCC) being the most common histological subtype. Copper exhibits dualism in HCC, as it both contributes to the growth and invasion of HCC cells, and exerts anticancer effects by inducing cuproptosis. Also, cuproptosis-related genes can be the evaluation of immunotherapy effect and the construction of prognostic models. Clarifying the role of copper death in liver cancer can help explore new methods for liver cancer screening, treatment, and prognosis evaluation.

Advantages of Combined Chinese and Western Medicine in Treating Liver Cancer

Primary liver cancer (abbreviated as hepatocellular carcinoma) is a malignant tumor occurring from intrahepatic bile duct cells or hepatocytes, which is one of the common malignant tumors in China. Early stage liver cancer is mainly treated by surgery, interventional therapy, local ablation therapy, immunotherapy, etc. However, most liver cancers are already in the middle and late stages when diagnosed, and western medical treatment has certain limitations; but at the same time, Chinese medicine treatment has certain advantages, which can improve postoperative status, enhance patients' immunity, improve patients' systemic symptoms, and help improve life quality. In this paper, we review the advantages of Western medical treatment combined with TCM in the treatment of primary hepatocellular carcinoma.

Upregulation of SCD1 by ErbB2 via LDHA promotes breast cancer cell migration and invasion.

The incidence of breast cancer ranks at the top of female malignant tumors in China. Metastasis remains the main cause of death among breast cancer patients. The overexpression of ErbB2 is closely related to the metastasis and poor prognosis of breast cancer patients. Therefore, ErbB2 is an important clinical therapeutic target of breast cancer. However, the molecular mechanism of ErbB2 promoting breast cancer metastasis has not been studied clearly. Stearoyl-CoA desaturase 1 (SCD1) is a key enzyme in catalyzing the conversion of saturated fatty acids (SFAs) into monounsaturated fatty acids (MUFAs). SCD1 is overexpressed in breast cancer, and its overexpression is an indicator of poor prognosis in breast cancer patients. However, the role of SCD1 in ErbB2-overexpressing breast cancer metastasis has not been reported. In this study, we investigated the role of SCD1 in the migration and invasion of ErbB2-overexpressing breast cancer cells and its molecular mechanism. First, we demonstrated that ErbB2 upregulates the expression of SCD1. Second, we found that SCD1 and its catalytic product oleic acid played crucial roles in migration and invasion of ErbB2-overexpressing breast cancer cells. Finally, we found that in breast cancer cells, ErbB2 upregulated SCD1 through lactate dehydrogenase A (LDHA). To sum up, upregulation of SCD1 by ErbB2 via LDHA promotes the migration and invasion of breast cancer cells.