Neoadjuvant Treatment Research Articles

BackgroundIn recent years, neoadjuvant immunotherapy combined with chemotherapy has shown enhanced therapeutic efficacy and favorable surgical safety profile in the treatment of resectable non-small cell lung cancer (NSCLC). Currently, there has been no academic research that directly compares the efficacy of two different immune checkpoint inhibitors (ICIs). This study aims to evaluate the differences of the short-term efficacy and surgery-related safety of two different ICIs (sintilimab and camrelizumab), in conjunction with chemotherapy and followed by radical surgical resection in patients diagnosed with resectable NSCLC.MethodsThis is a single-center retrospective cohort study involving patients. All patients diagnosed with NSCLC at Tangdu Hospital between June 2018 and March 2024, who received neoadjuvant therapy involving programmed cell death protein-1 (PD-1) inhibitors (specifically sintilimab or camrelizumab) in combination with chemotherapy and followed underwent surgical interventions, were consecutively enrolled in the study. Subsequently, in order to control confounding variables as much as possible, we innovatively employed two novel matching methods based on baseline characteristics: the 1:1 propensity score matching (PSM) method and the inverse treatment probability weighting (IPTW). We compare the efficacy and surgical safety of two different ICIs for patients with resectable NSCLC.ResultsIn total, 239 patients were enrolled, including 134 patients in the sintilimab group (SG) and 105 in the camrelizumab group (CG). Before PSM, the pathological complete response (pCR) rate did not differ between the SG and CG groups (42.5% vs. 35.2%, P=0.25). Similarly, the major pathologic response (MPR) rate (55.9% vs. 60.0%, P=0.53) and the objective response rate (ORR) (73.1% vs. 66.7%, P=0.28) rate were not different between the groups. Binary logistic analysis revealed that squamous cell carcinoma was a promoter of pCR [P=0.01, 95% confidence interval (CI): 15.2–77.6]. In total, 91 pairs of patients were matched by PSM. No differences were observed in the pCR rate (45.1% vs. 39.6%, P=0.45), the MPR rate (58.2% vs. 64.8%, P=0.36) and the ORR rate (75.8% vs. 67.0%, P=0.19) between the SG and CG groups.ConclusionsIn the neoadjuvant chemoimmunotherapy treatment of resectable NSCLC, sintilimab and camrelizumab demonstrated comparable short-term efficacy and surgical safety when administered in conjunction with chemotherapy.

The prognostic and predictive role of the interaction of the immune system with the tumor during the disease process has become increasingly important in recent years. T lymphocyte subgroups in peripheral blood can be used to monitor this dynamic interaction. We evaluated the relationship between baseline peripheral T lymphocyte subsets and treatment response (best objective response) in 47 breast cancer patients receiving neoadjuvant chemotherapy. This study investigated the impact of initial peripheral T lymphocyte subsets on neoadjuvant chemotherapy response in patients with invasive ductal breast. A total of 47 consecutive patients whose peripheral blood samples were able was included in the study group. The patients' T lymphocyte subsets were measured before treatment. The patients were then followed up to assess their treatment response. In our study, we found a significant negative relationship between baseline CD3, CD4, and CD8 absolute counts and pathologic complete response. We also found that high CD4/programmed cell death protein 1 expression (OR: 0.212, 95% CI: 0.061-0.735, P = .015) and high CD8/programmed cell death protein 1 expression (OR: 0.250, 95% CI: 0.073-0.858, P = .028) from baseline peripheral T lymphocyte were correlated with poor pathologic complete response. These results suggest that T lymphocyte subsets may be a predictive biomarker for treatment response in patients with breast cancer undergoing neoadjuvant chemotherapy. Further studies are needed to confirm these findings and to identify the optimal T lymphocyte subset for predicting treatment response.

The surgical treatment is still the most effective method in curing of early breast cancer. Breast preservation and the application of oncoplastic principles became generally accepted, the sentinel lymph node biopsy in the surgical treatment of the axilla is primary, and the indication for axillary block dissection (ABD) is narrowing further. The neoadjuvant oncological treatment that is applied more and more widely presented surgery with new challenges. The expansion of quality assurance measures, the enhancement of breast surgery training, and the acceleration of centralisation through the establishment of dedicated breast cancer diagnostic and treatment centres are all anticipated to contribute significantly to the reduction of breast cancer mortality. Hereunder we summarise our recommendations on the surgical treatment of breast cancer based on the content of the 5th Breast Cancer Consensus Conference and considering the latest international studies and professional recommendations.

Luminal apposing metal stent (LAMS) has been used to create endoscopic large-caliber communications between different organs.1 LAMS has an anti-migration design. Dilation is progressive and does not cause ischemia or inflammation. There is no tissue loss, as with stapled anastomosis, we do not have any intercepting staple line.2-7 Being coated allows for early refeeding. The aim of this study was to assess the preliminary results of the use of the LAMS in surgical gastrointestinal anastomoses. An 82-year-old patient underwent robotic proximal esophagogastric resection for bulky esophagogastric junction (EGJ) gastrointestinal stromal tumors (GIST) and intrathoracic esophagogastric anastomoses with LAMS. Lumen diameter used was 20 mm. The patient could not undergo neoadjuvant treatments because the lesion was bleeding. Proximal gastrectomy is a valuable option for selected patients with GISTs of the gastric fundus or EGJ. It offers excellent oncologic results with superior functional outcomes compared to total gastrectomy.8-11 To our knowledge, this is the first report in the world to use this technique. Operative time was 180 min and hospital stay was 7 days. We did not record any perioperative surgical complications even after stent removal. The final histology showed a GIST pT4 N0 M0. At the 6-month follow-up we did not record any symptoms of reflux or signs of stenosis. The patient has a good nutritional status. Our preliminary experience shows that this approach is feasible and safe. It could become the new standard of care and reduce the risk of anastomotic leakage in at-risk anastomoses. Randomized controlled trials in large populations are needed.

To further standardize lung cancer prevention and treatment measures in China, enhance the quality of diagnosis and treatment, improve patient prognosis, and provide evidence-based medical guidance for clinicians at all levels, the Chinese Medical Association convened experts from respiratory medicine, oncology, thoracic surgery, radiotherapy, imaging, and pathology to develop the "Chinese Medical Association's clinical diagnosis and treatment guidelines for lung cancer (2025 edition)". This consensus resulted in several updates from the 2024 version. In the screening section, a new recommendation has been added to specify populations not advised to undergo lung cancer screening. It also emphasizes that individuals at high risk for lung cancer should be fully informed of the potential benefits and risks of low-dose CT (LDCT) screening before undergoing the examination. With the advancement of treatment options, updates have been made to the recommended genetic testing for patients with early- and mid-stage postoperative and advanced non-small cell lung cancer (NSCLC). For patients with advanced epidermal growth factor receptor (EGFR) mutations, in addition to a broader range of monotherapy options, the application of combination therapies may offer better disease control for certain patients. Furthermore, more treatment options have been approved for patients undergoing immunotherapy-based neoadjuvant treatment and for those who develop resistance to EGFR tyrosine kinase inhibitors (TKIs). For patients with previously limited treatment options, such as those with KRAS G12C mutations, HER-2 mutations, or small cell lung cancer after resistance development, the approval of novel drugs has brought significantly improved efficacy and prognosis. These recommendations are based on state-approved drug applications, international guidelines, and current clinical practices in China, integrating the latest evidence-based medical research in screening, diagnosis, pathology, genetic testing, immune molecular marker detection, treatment methods, and follow-up care. The goal is to provide comprehensive and reasonable recommendations for clinicians, imaging specialists, laboratory technicians, and other medical staff at all levels.

Emerging data support the use of neoadjuvant treatment (NAT), particularly immunotherapy in microsatellite instability-high (MSI-H) tumors. We evaluate national trends in NAT utilization for clinical T4b colon cancers and its association with overall survival, with a focus on MSI-H tumors. We conducted a retrospective cohort study using the National Cancer Database (2010-2022) evaluating patients with non-metastatic clinical T4b colonic adenocarcinoma who underwent colectomy. The primary outcome measures were trends in NAT utilization and overall survival. Among 8862 patients with clinical T4b colon cancer, NAT utilization increased over time, peaking at 28% in the most recent quartile. NAT recipients were more likely younger, healthier, and to be treated at academic centers. NAT was associated with higher R0 resection rates (83% vs 77%, p < 0.001) and significantly longer mean overall survival (105 vs 80 months, p < 0.001). Among MSI-H patients (11% of the cohort), 15% received NAT. Immunotherapy use increased steadily, surpassing chemotherapy in 2022. Patients receiving neoadjuvant immunotherapy +/- chemotherapy demonstrated superior survival to chemotherapy alone (106 vs 85 months, p < 0.001). Neoadjuvant therapy use has increased nationally, with a notable rise in immunotherapy for MSI-H tumors. Neoadjuvant treatment, particularly immunotherapy, is associated with significant overall survival benefit.

Novel multimodal treatment strategies might enable curative-intent resection of locally advanced pancreatic cancer (LAPC). While venous resections are routinely performed, arterial resections remain part of individualized treatment strategies in a few expert centers. Historically, SMA involvement, by definition, precluded resectability. However, in selected patients with excellent response to preoperative treatment, arterial resection has been associated with satisfactory outcomes in high-volume centers with significant experience in extended and vascular resections. Even though arterial divestment is increasingly performed if technically possible, arterial resection is still required when the arterial wall cannot be preserved to achieve macroscopically complete resection, especially if the SMA is encased along with its branches in SMA segment 2. Usually, the SMV is also encased in these tumors, and combined arterial and venous resections are necessary. Here, we describe our approach to SMA resection and reconstruction after neoadjuvant treatment in a 64-year-old female patient with locally advanced pancreatic ductal adenocarcinoma (PDAC) and complete encasement of the SMA in segment 2. Critical steps in this situation are assessing the feasibility of SMA and SMV resection using an infracolic artery first approach, performing a wide Kocher maneuver to access the SMA from the right, and the Cattell-Braasch maneuver to enable tension-free direct end-to-end anastomoses.

To evaluate the efficacy and safety of a chemotherapy-free regimen consisting of monoclonal antibody trastuzumab, tyrosine kinase inhibitor pyrotinib and CDK4/6 inhibitor dalpiciclib in patients with hormone receptor-negative/HER2-positive (HR-HER2+) early breast cancer (EBC). This open-label, single-arm, phase II study was designed using the Simon two-stage method (Chi-CTR-2200060748). Patients with operable HR-HER2+EBC (T1-3 and N0-2) were enrolled. Eligible patients received trastuzumab (HLX02, 8mg/kg loading dose, followed by 6mg/kg every 3weeks intravenously), pyrotinib (400mg daily orally) and dalpiciclib (125mg daily orally for 3weeks, followed by 1week off) for 16weeks. Surgery was performed 3-6weeks after the completion of drug treatment. The primary endpoint was total pathological complete response (tpCR, ypT0/Tis, ypN0) rates at surgery, and secondary endpoints included breast pCR (bpCR) rates (ypT0/Tis), residual cancer burden (RCB), objective response rate (ORR), change of Ki-67 scores, survival and safety. Between Jun, 2022, and Jun, 2024, a total of 34 patients with a median age of 55years (range: 35-67) were enrolled. 30 patients received all cycles of treatment and underwent surgery with a median follow-up of 20months. The tpCR was achieved in 19 patients (63.3%; 95% CI, 45.5-78.1%). The bpCR was 66.7% (20/30). The number of patients with RCB-0 or RCB-I was 22 (73.3%). The most common Grade 3 treatment-related adverse events were diarrhea (50.0%), neutropenia (20.6%), and leukopenia (17.7%). No Grade 4 events or treatment-related deaths occurred. In patients with HR-HER2+EBC, the neoadjuvant therapy with trastuzumab, pyrotinib and dalpiciclib has promising activity and manageable toxicity. Further investigation is needed.

Background/Objectives: Management of cancer treatment-induced bone loss (CTIBL) is essential for preserving quality of life among breast cancer (BC) patients receiving endocrine therapy. However, bone-modifying agents (BMAs) remain underused and delayed. In 2014, IRST launched the first bone health outpatient service in Romagna (the eastern area of the Emilia-Romagna region). A multi-centre, retrospective observational study with propensity score matching (PSM) was conducted to evaluate the impact of the IRST organisational model on bone health. Methods: The PSM matched the Emilia-Romagna patients who underwent BC surgery between 2014 and 2022 and were in follow-up in the Romagna area. Patients were grouped as follows: (1) IRST and (2) other Romagna hospitals (without bone health service, i.e., the control group). The matching was based on age, in situ/invasive cancer, and type of early-stage treatment (hormone treatment vs. chemotherapy). Logistic regression and Cox proportional-hazard models assessed factors associated with bone care treatment initiation and timings, respectively. Results: After PSM, we matched 3112 of the 8021 eligible patients into the two cohorts. IRST patients were 39% more likely to receive BMAs (OR: 1.393; 95% CI: 1.236–1.571) and initiated treatment approximately 12 months earlier. We observed that patients with invasive tumours were 77% more likely to initiate bone therapy than those with in situ tumours (OR: 1.766; 95% CI: 1.237–2.585). The early initiation of bone health therapy was influenced by age (p < 0.001) and neoadjuvant chemotherapy treatment (p < 0.001). Conclusions: The IRST model demonstrates responsiveness to bone health needs in BC patients and may be implemented elsewhere to support integrated CTIBL care.

Long-term Results from the LEA Randomized Trial: Extended Versus Standard Lymph Node Dissection in Patients with Bladder Cancer Undergoing Radical Cystectomy.

To predict histologic grade of soft tissue sarcoma (STS) with preoperative ultrasound images, aiding in the selection of personalized treatment plans and improving long-term prognosis. In total, 238 patients with histologically proven STS were retrospectively enrolled from April 2016 to December 2023 and divided into the training and internal validation cohorts. 70 patients were prospectively enrolled from three centers between January 2024 and December 2024 as the external validation cohort. Radiomics features were extracted from preoperative grayscale ultrasound images. The dynamic nomogram (DynNom) was developed by using multivariable logistic regression analysis. Predictive performance was evaluated with the receiving operating characteristic curve, calibration curve, Hosmer-Lemeshow test, decision curve analysis (DCA), and clinical impact curve (CIC). The DynNom based on clinical-US characteristics (metastasis status, echogenicity, fascia layer, and vascularity) and radiomics features yielded an optimal AUC of 0.915 (95% CI, 0.873-0.947), 0.87 (95% CI, 0.79-0.93), and 0.90 (95% CI, 0.80-0.96) for predicting the STS histologic grade in the training, internal and external validation cohorts, respectively. The DynNom outperformed the conventional model and radiomics model (P < 0.05). Calibration curves and Hosmer-Lemeshow tests indicated its satisfactory calibration ability. DCA confirmed that the DynNom outperformed other models in overall net benefit, meanwhile CIC suggested that the DynNom had great clinical applicability in predicting histologic grade. The dynamic nomogram is a practical tool that could predict the histologic grade of STS, which might help clinicians to screen histologic high-grade STSs as neoadjuvant treatment candidates. The dynamic nomogram had the potential to accurately predict histologic grade in STS patients before surgery. High-risk patients defined by the dynamic nomogram were potential candidates for preoperative radiotherapy and neoadjuvant chemotherapy.

Patients with HER2-low breast cancer (BC) may be eligible for trastuzumab-deruxtecan (T-DXd) treatment. However, studies have shown that different HER2 antibodies vary in their sensitivity for low HER2 expression, potentially impacting HER2-low BC diagnosis and patient selection for T-DXd. We investigated the frequency of HER2-low BC in relation to the HER2-antibody used across Dutchpathology laboratories. Patients with primary BC without neoadjuvant treatment, diagnosed between 2013 and 2024, were included. HER2-low frequencies from 34 laboratories were obtained from the Dutch Nationwide Pathology Databank (Palga). Additional information (e.g., type of HER2 antibody, staining protocol) was obtained through a questionnaire. A total of 88,713 patients were included, representing 103,505 tumors, of which 94,934 had a conclusive HER2 status. Among non-amplified cases, HER2-low frequencies varied widely across laboratories (33.4%-94.5%), with a gradual increase since 2022. The most commonly used antibody clones were 4B5 (n = 21), DG44 (n = 7), A0485 (n = 4), and SP3 (n = 2). HER2-low proportions were highest with A0485 (71.5%), followed by DG44 (66.7%), SP3 (60.1%), and 4B5 (59.1% with Ultraview, 57.0% with Optiview). Substantial inter-laboratory variation was observed even within the same antibody group (4B5/Ultraview: 40.5%-80.4%; 4B5/Optiview: 37.3%-68.4%; DG44: 40.6%-95.4%; A0485: 62.3%-94.7%; SP3: 31.6%-78.6%). Our data showed a notable variation in HER2-low BC frequency across Dutch pathology laboratories, even among those using the same antibody and detection system. These differences may influence patient eligibility for T-DXd.

ASO Visual Abstract: Accuracy of PET-CT to Assess the Extent of Nodal Disease in Patients with Clinical Stage III Melanoma Following Neoadjuvant Treatment.

Neoadjuvant systemic therapy may enhance ocular and visual preservation, also prolonging life in patients with choroidal melanoma. We investigated how many choroidal melanomas would be eligible for such treatment to enable Ruthenium-106 brachytherapy. The cohort comprised 5859 patients treated for choroidal melanoma at the Liverpool Ocular Oncology Centre between 1993 and 2023. If the objective is ocular conservation, then, after excluding tumors > 16 mm in diameter, involving disc and/or more than two clock hours of angle or iris, and/or extending extraocularly, approximately 60.5%, 65.1%, and 67.6% of patients would remain eligible for neoadjuvant systemic therapy, according to whether the maximum allowable tumor thickness is 8 mm, 10 mm or 12 mm, respectively. If the objective is preservation of 20/80 vision, and if exclusion criteria also include vision worse than 20/80 and tumor extension to within 3 mm of optic disc and/or fovea, then 31.0%, 33.2% and 34.1% of tumors would remain in the three tumor-thickness groups, respectively. Chromosome 3 loss would be found in approximately 33%, 52% and 56% of tumors measuring 11-12 mm, 13-14 mm and >14 mm, respectively. Based on the provided data and with effective neoadjuvant treatment, approximately two thirds of subjects with choroidal melanoma requiring enucleation could potentially become candidates for ruthenium-106 brachytherapy and as many as one third could also have the potential for preservation of useful vision.

Breast cancer remains a significant public health concern, and neoadjuvant therapy has significantly reconfigured the landscape of its clinical management. The intricate characteristics of the tumor microenvironment (TME) have profound implications for tumor development and therapeutic responses. Thus, understanding the dynamics of the TME during treatment is crucial. Advancements in molecular biology research, such as single-cell analysis and spatial omics technologies, provide valuable tools for investigating the complexities of the breast cancer microenvironment. These innovative approaches facilitate the identification of cellular heterogeneity, spatial interactions, and altered signaling pathways, illuminating the TME's adaptive mechanisms in response to neoadjuvant therapy. In this review, we first elucidate the current status of neoadjuvant therapy in breast cancer. Subsequently, we outline cutting-edge molecular biology research methods and their applications within the breast cancer microenvironment. Finally, we provide an overview of the alterations in the components of the tumor microenvironment during neoadjuvant treatment for breast cancer, focusing on insights gained from single-cell analysis and spatial pathology.

Background: Breast cancer screening and effective neoadjuvant treatments have increased surgeries for nonpalpable tumors, often requiring preoperative localization. The wire-guided method, performed on the same day as surgery, has limitations, prompting interest in wire-free alternatives like magnetic seed devices.Methods: A retrospective single-center study (November 2020–March 2024) compared magnetic seed and wire-guided localization in 558 patients. The primary aim was to assess localization and retrieval success, resection margins, and reoperation rates. Secondary endpoints included the interval between localization and surgery, operative time, incision site selection, and volume excised.Results: Among 558 patients, 188 underwent magnetic seed and 370 wire-guided localizations. Both groups were similar in BMI, breast size, and lesion characteristics. Complications in the wire-guided group included device migration (0.5%) and hematoma (1.3%). Success rates were comparable (98.9% vs. 99.7%), as were positive margins (5.3% vs. 6.7%) and reoperation rates (6.9% vs. 7.8%). Excised volume was significantly lower in the magnetic seed group (24.2 [range 6.5–48.0 cm3] vs. 41.5 cm3 [range 16.0–68.0 cm3], p < 0.001). The magnetic seed group had an average localization-to-surgery interval of 1 day (range 0–160 days).Conclusions: Magnetic seed localization is as safe and effective as wire-guided localization, with comparable success rates and resection margins adequacy. Its primary advantage is scheduling flexibility, offering a longer interval between localization and surgery.

Rectal cancer radiotherapy: 2025 update.

To evaluate the association between the KRAS mutational load and the histologic tumor response in patients with resectable pancreatic ductal adenocarcinoma (PDAC) who received neoadjuvant treatment (NAC) with pegylated liposomal irinotecan in combination with oxaliplatin, 5-fluorouracil, and leucovorin (NALIRIFOX). This was a multicenter, single-arm, interventional, open-label, phase 2 trial in patients 18 years or older who had histologically or cytologically confirmed PDAC and were candidates for surgery and received neoadjuvant NALIRIFOX. The primary outcome was determination of the association between the KRAS mutational load and the histologic tumor response after chemotherapy. Twenty patients were included in the study. Before initiating NAC, 11 patients were KRAS+, 6 were KRAS-, and 3 were not evaluable for KRAS mutation status. Eight of the 11 (72.7%) patients changed from KRAS+ at baseline to KRAS- after treatment, and none of the 6 (0.0%) patients changed from KRAS- at baseline to KRAS+ after treatment. A good histopathologic response after NAC was observed in 3 (15%) of the 20 patients, with a greater proportion of good responses among patients who were KRAS- (3 out of 16 [18.8%]) than among those who were KRAS+ (0 out of 1 [0.0%]) after NAC, although the differences were not statistically significant (P=0.633). Our results indicate that patients with potentially resectable PDAC tend to have detectable KRAS in the blood if the disease is locally more advanced and that most patients who are treated with neoadjuvant NALIRIFOX are negative for KRAS at the end of therapy.

Background: Multidisciplinary Tumor Councils (MDTs) are vital platforms that provide tailored treatment plans for cancer patients by combining expertise from various medical disciplines. Recently, Artificial Intelligence (AI) tools have been investigated as decision-support systems within these councils. Methods: In this prospective study, the compatibility of AI (ChatGPT-4.0) with MDT decisions was evaluated in 100 cancer patients presented to the tumor council between November 2024 and January 2025. AI-generated treatment recommendations based on anonymized, detailed clinical summaries were compared with real-time MDT decisions. Cohen’s Kappa and Spearman correlation tests were used for statistical analysis. Results: Neoadjuvant treatment (45%) and surgery (36%) were the most frequent MDT decisions. AI recommended surgery (39%) and neoadjuvant treatment (37%) most frequently. A high concordance rate of 76.4% was observed between AI and MDT decisions (κ = 0.764 [95% CI; 0.658–0.870] p < 0.001, ρ = 0.810 [95% CI; 0.729–0.868], p < 0.001). Most inconsistencies arose in cases requiring individualized decisions, indicating AI’s current limitations in incorporating contextual clinical judgment. Conclusion: AI demonstrates substantial agreement with MDT decisions, particularly in cases adhering to standardized oncological guidelines. However, for AI integration into clinical workflows, it must evolve to interpret real-time patient data and function transparently within ethical and legal frameworks.

To further standardize lung cancer prevention and treatment measures in China, enhance the quality of diagnosis and treatment, improve patient prognosis, and provide evidence-based medical guidance for clinicians at all levels, the Chinese Medical Association convened experts from respiratory medicine, oncology, thoracic surgery, radiotherapy, imaging, and pathology to develop the Chinese Medical Association's Clinical diagnosis and treatment guidelines for lung cancer (2025 edition). This consensus resulted in several updates from the 2024 version. In the screening section, a new recommendation has been added to specify populations not advised to undergo lung cancer screening. It also emphasizes that individuals at high risk for lung cancer should be fully informed of the potential benefits and risks of low-dose CT (LDCT) screening before undergoing the examination. With the advancement of treatment options, updates have been made to the recommended genetic testing for patients with early-and mid-stage postoperative and advanced non-small cell lung cancer (NSCLC). For patients with advanced EGFR mutations, in addition to a broader range of monotherapy options, the application of combination therapies may offer better disease control for certain patients. Furthermore, more treatment options have been approved for patients undergoing immunotherapy-based neoadjuvant treatment and for those who develop resistance to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKI). For patients with previously limited treatment options, such as those with KRAS G12C mutations, HER2 mutations, or small cell lung cancer after resistance develops, the approval of novel drugs has brought significantly improved efficacy and prognosis. These recommendations are based on State-approved drug applications, international guidelines, and current clinical practices in China, integrating the latest evidence-based medical research in screening, diagnosis, pathology, genetic testing, immune molecular marker detection, treatment methods, and follow-up care. The goal is to provide comprehensive and reasonable recommendations for clinicians, imaging specialists, laboratory technicians, and other medical staff at all levels.