Table of Content

25 October 2025, Volume 17 Issue 5 Previous Issue   

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Liquid biopsy in bladder cancer: Progression from single biomarkers to multi-omics integration for diagnosis,follow-up,and prediction of therapeutic response LU Xiaole, CHEN Xu, CHENG Liang, HUANG Jian 2025, 17 (5):  523-531.  doi: 10.3969/j.issn.1674-5671.2025.05.01 Abstract ( 29 )   PDF (708KB) ( 7 )   Save Bladder cancer is among the most prevalent malignancies affecting the urinary system. Patients diagnosed with non⁃muscle⁃invasive bladder cancer (NMIBC) necessitate prolonged and intensive surveillance due to the disease's  high recurrence rate. Although cystoscopy remains the "gold standard" for diagnosis and monitoring, its invasive nature poses risks of pain, infection and hematuria, which can lead to poor compliance. In recent years,  liquid biopsy technologies have rapidly advanced, with various detection methods based on protein, fluorescence in situ hybridization, RNA, DNA mutation, copy number variation, DNA methylation, circulating tumor DNA (ctDNA) have shown significant promising  in the early diagnosis, recurrence monitoring and prognosis assessment of bladder cancer. Despite these advancements, the clinical implementation of these biomarkers faces substantial challenges and has not yet been adopted as  a routine diagnostic approach. This review systematically summarizes the research progress on liquid biopsy biomarkers for bladder cancer and explores the potential of multi⁃omics integration strategies to enhance the clinical translational value. Related Articles | Metrics

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Applications and development of medical large language models in cancer diagnosis LIANG Ting, WU Yijian , WANG Yuliang , ZHONG Jianye, LIU Xiaohong 2025, 17 (5):  532-540.  doi: 10.3969/j.issn.1674-5671.2025.05.02 Abstract ( 24 )   PDF (1070KB) ( 7 )   Save The advent of medical large language models (LLMs) has created new opportunities for intelligent cancer diagnosis. Compared to traditional clinical decision support systems that rely on empirical knowledge and rule⁃based methodologies, LLMs possess the capability to capture intricate semantic representations and latent relationships within multimodal clinical data. The large⁃model technology framework is driving the intelligent transformation in tumor diagnosis, enhancing the accuracy and logical reasoning of clinical decisions, improving the organization of medical knowledge, and strengthening physicians’ analytical capabilities in complex cases. Despite persistent challenges in interpretability, reliability, and data privacy persist, these models are establishing a robust foundation for the clinical realization of intelligent medicine. This article summarizes critical  advances in the application of medical LLMs for cancer diagnosis, including progress in model architecture optimization, domain adaptation, and multimodal data integration. It explores the potential in key scenarios such as clinical information extraction, joint imaging⁃pathology analysis, and digital diagnostic support, providing systematic reference for cancer research and clinical practice. Related Articles | Metrics

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Perioperative safety management strategies and clinical outcomes in patients with renal cell carcinoma complicated by heart failure WANG Wei, ZHAO Jiahui, CUI Jiayuan, HONG Bao'an, LYU Qiang, WANG Sheng, CHEN Chen, LI Quan, ZHANG Jingrui, CHU Huijun, ZHANG Xuezhou, WANG Yuxuan, SUN Zhipeng, BO Yuxuan, MIAO Qi, TANG Yibo, ZHANG Ning 2025, 17 (5):  541-547.  doi: 10.3969/j.issn.1674-5671.202c Abstract ( 25 )   PDF (893KB) ( 4 )   Save Objective To preliminarily explore perioperative safety management strategies for patients with renal cell carcinoma (RCC) complicated by heart failure (HF). Methods The clinical data from patients with RCC complicated by HF who underwent surgery at Beijing Anzhen Hospital, Capital Medical University, from March 2023 to March 2025 were retrospectively analyzed. The clinical data included baseline characteristics, cardiac functional parameters, operative variables, perioperative management strategies, in⁃hospital complications, and postoperative outcomes, which were obtained through telephone follow⁃up. For statistical analysis, the Wilcoxon rank⁃sum test and Kruskal⁃Wallis test were used to compare non⁃normally distributed data across different groups, while the Wilcoxon signed⁃rank test was used to assess changes in B⁃type natriuretic peptide (BNP) levels pre⁃ and postoperative. Multivariable linear regression was performed to analyze correlations among continuous variables to identify baseline or perioperative factors influencing safety outcomes. Results Twenty patients were enrolled, comprising 18 males and 2 females. According to New York Heart Association(NYHA) classification, gradeⅡ in 2, grade Ⅲ in 15, and gradeⅣin 3 patients. The left ventricular ejection fraction (LVEF) was ≤30% in 5, 30%<LVEF≤40% in 8, 40%<LVEF≤49% in 4, and LVEF≥50% in 3 patients. Radical nephrectomy was performed in 18 patients, while partial nephrectomy in 2 patients. The median operative time was 100.00 (88.75, 110.00) mins, and the median intraoperative blood loss was 20.00 (10.00, 50.00) mL. Postoperative day⁃1 BNP levels were significantly higher than preoperative levels [274.00 (204.25-393.50) pg/mL vs 94.00 (50.00-229.50) pg/mL，　P=0.004]. Two perioperative complications occurred within 30 d, including one acute myocardial infarction and one stress⁃related gastric ulcer, and no episodes of acute decompensated HF were observed. The median follow⁃up duration was 18.5 (4.0-28.0) months. Nineteen patients survived, while one patient died due to distant tumor metastasis. NYHA functional class improved by 2 levels in 6 patients, by 1 level in 10 patients, remained unchanged in 2 patients, and worsened by 1 level in 1 patient, demonstrating a significant improvement in postoperative cardiac function compared with preoperative status. Conclusions Nephrectomy is safe and feasible for RCC patients with NYHA class Ⅱ-Ⅳ　HF (LVEF 25%-60%) when preceded by comprehensive preoperative evaluation and medical adjustment, optimized intraoperative anesthetic management, and vigilant postoperative monitoring and pain control. No perioperative episodes of acute decompensated HF occurred, and postoperative cardiac function improved, suggesting that surgical treatment can be safely performed in RCC patients with HF under structured perioperative management strategies. Related Articles | Metrics

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Clinical research of Xinmailong injection in reducing cardiovascular toxicity associated with adjuvant chemotherapy after breast cancer surgery LYU Dan, LAN Bo, LIU Binliang, MA Fei 2025, 17 (5):  548-554.  doi: 10.3969/j.issn.1674-5671.2025.05.04 Abstract ( 22 )   PDF (689KB) ( 4 )   Save Objective To observe and evaluate the efficacy of Xinmailong injection in reducing cardiovascular toxicity associated with adjuvant chemotherapy following breast cancer surgery. Methods Female breast cancer patients who underwent radical mastectomy and subsequently received 8 cycles of adjuvant chemotherapy with a regimen of epirubicin hydrochloride and cyclophosphamide followed by paclitaxel, at the Cancer Hospital of the Chinese Academy of Medical Sciences, between March 2019 and December 2019 were enrolled. Patients were randomized into the Xinmailong injection group or the Dexrazoxane group to receive Xinmailong injection or dexrazoxane for cardiac toxicity prevention, respectively. Changes of myocardial injury markers including cardiac troponin T (cTnT), B⁃type natriuretic peptide (BNP), creatine kinase MB isoenzyme (CK⁃MB) were compared between the two serum groups before and after treatment. Echocardiography was used to assess the ratio of early⁃to⁃late diastolic filling velocities (E/A), left ventricular ejection fraction (LVEF), left ventricular end⁃systolic diameter (LVESD), and left ventricular end⁃diastolic diameter (LVEDD). Electrocardiographic changes and adverse events were also monitored. Results A total of 60 patients were enrolled, with 30 in each group. After treatment, the cTnT level increased by 0.006 ng/mL in the Xinmailong injection group, while decreased by 0.020 ng/mL in the Dexrazoxane group, indicating that Xinmailong injection was less effective than Dexrazoxane in reducing cTnT levels (P<0.001). BNP levels decreased by 3.130 pg/mL in the Xinmailong injection group and by 0.204 pg/mL in the Dexrazoxane group, indicating a better prevention of BNP elevation with Xinmailong injection (P=0.167). No significant differences were observed between groups in the changes of CK⁃MB, E/A ratio, LVESD, LVEF and LVEDD; the total number of new cardiac events, new ST⁃T segment changes, new QT interval prolongation, new AV block, and new ventricular premature contractions after treatment; as well as in the incidence of adverse events such as nausea and vomiting, dizziness, headache, or bone marrow suppression (leukopenia)  (all P>0.05). All related adverse reactions improved after symptomatic treatment. Conclusions Xinmailong injection demonstrated favorable safety and potential efficacy in preventing anthracycline⁃induced cardiac toxicity. It may show superiority over Dexrazoxane in preventing BNP elevation, but its ability to reduce cTnT levels was inferior to Dexrazoxane.  Related Articles | Metrics

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Clinical features and risk factors of Trastuzumab-induced cardiotoxicity in breast cancer MA Zhongjing, ZHANG Yanli, CHEN Pan, CHEN Junyi, LI Jia, ZHANG Jingjiao, LIU Ying, XIA Yunlong, FANG Fengqi 2025, 17 (5):  555-561.  doi: 10.3969/j.issn.1674-5671.2025.05.05 Abstract ( 19 )   PDF (803KB) ( 1 )   Save Objective To retrospectively analyze the incidence and influencing factors of Trastuzumab⁃induced cardiovascular toxicity among breast cancer patients and to explore the risk stratification efficacy of the Heart Failure Association (HFA) of the European Society of Cardiology⁃International Cardio⁃Oncology Society (ICOS) score. Methods This analysis included 298 patients with human epidermal growth factor receptor 2 (HER2)⁃positive breast cancer who received Trastuzumab treatment at the First Affiliated Hospital of Dalian Medical University between June 2012 and June 2024. Baseline risk assessment for cancer therapy⁃related cardiovascular toxicity (CTR⁃CVT) was performed using the HFA⁃ICOS score recommended by the 2022 European Society of Cardiology guidelines, categorizing patients into low⁃, intermediate⁃, high⁃, and very⁃high⁃risk groups. Univariable analysis and multivariable Logistic regression  model were used to identify risk factors for cardiovascular toxicity. Results Among the 298 patients, the incidence of Trastuzumab⁃related cardiovascular toxicity was 7.4% (22/298), including arrhythmias (68.2%, 15/22), cancer therapeutics⁃related cardiac dysfunction (27.3%, 6/22), and vascular toxicity (4.5%, 1/22). Independent risk factors for cardiovascular toxicity in HER2⁃positive breast cancer patients treated with Trastuzumab were identified as Ki⁃67 ≥30%, anthracycline⁃containing regimens, and smoking history (all P<0.05). The HFA⁃ICOS score indicated that the incidence of CTR⁃CVT in high⁃risk patients (25.0%) was higher than in low⁃risk (5.6%) and medium⁃risk (9.6%) patients. Conclusions Trastuzumab⁃related cardiovascular toxicity primarily manifests as arrhythmias, with associated risk factors including anthracycline use, smoking history, comorbid coronary heart disease, and Ki⁃67≥30%. Clinically, the HFA⁃ICOS score can be utilized for risk stratification to implement differentiated monitoring. Related Articles | Metrics

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Trends in incidence and mortality of prostate cancer in Gansu Pro-vince from 2010 to 2021 and its predictive analysis ZHANG Bolun, WANG Jia, ZHU Jiahe, XING Dehao, DING Gaoheng, LIU Yuqin 2025, 17 (5):  562-567.  doi: 10.3969/j.issn.1674-5671.2025.05.06 Abstract ( 14 )   PDF (646KB) ( 2 )   Save Objective To analyze the trends in incidence and mortality of prostate cancer in Gansu Province from 2010 to 2021 and to forecast its trajectories from 2022 to 2030. Methods Based on the incidence and mortality data of prostate cancer from fifteen cancer registries in Gansu Province from 2010 to 2021, incidence and mortality rates were calculated by age⁃specific and urban⁃rural⁃specific data, respectively. Population standardization was performed using the 2000 Chinese standard population structure to calculate age⁃standardized rate by the Chinese standard population (ASIRC), and the age⁃standardized mortality by the Chinese standard population (ASMRC), the average annual percentage change (AAPC) and corresponding 95% confidence interval (CI) were calculated. The incidence and mortality rates for 2022—2030 were predicted using the Bayesian Age⁃Period⁃Cohort (BAPC) model. Results From 2010 to 2021, both the incidence and mortality rates of prostate cancer in Gansu Province showed an upward trend. The ASIRC increased by 8.12% annually （AAPC=8.12%，95%CI： 3.52%-12.93%， P=0.003）. In urban regions, the ASIRC increased by 14.88% annually （AAPC=14.88%，95%CI： 8.56%-21.57%， P<0.001）, whereas in rural areas, it decreased by 1.17% annually （AAPC=-1.17%， 95%CI： -7.53%-5.60%， P=0.699）. ASMRC showed an annual increase of 6.83% (AAPC=6.83%, 95%CI: -2.93%-17.58%, P=0.177), with urban areas increased by 14.82% annually (AAPC=14.82%, 95%CI: 2.42%-28.73%, P=0.023), while rural areas showed an annual decrease of 1.31% (AAPC =−1.31%, 95%CI: −8.75%-6.74%, P=0.716). The ASIRC increased across all age groups over 40, whereas the ASMRC rose in age groups over 50. Projections for 2022—2030 indicated continued increases in both incidence and mortality rates, with rates expected to reach 39.97/105 and 29.51/105 by 2030, respectively. Conclusions The incidence and mortality rates of prostate cancer in Gansu Province increased from 2010 to 2021. Middle⁃aged and elderly populations, as well as urban areas, exhibited higher risks of incidence and mortality. Screening, early diagnosis and treatment for prostate cancer should be strengthened in high⁃risk regions and populations. Related Articles | Metrics

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Prediction risk of radiation proctitis after neoadjuvant chemoradiotherapy in locally advanced rectal cancer using CT radiomics  CAO Qian, ZHOU Meng, ZHANG Zhen, ZHU Ji 2025, 17 (5):  568-575.  doi: 10.3969/j.issn.1674-5671.2025.05.07 Abstract ( 16 )   PDF (1231KB) ( 1 )   Save Objective To develop a machine learning model based on computed tomography (CT) radiomics for predicting the risk of radiation proctitis in patients with locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (nCRT). Methods Patients with LARC underwent nCRT at Zhejiang Cancer Hospital from December 2021 to December 2024 were retrospectively enrolled as the training set (n=326), while patients underwent nCRT from August 2022 to August 2024 were prospectively enrolled as the validation set (n=104). The region of interest in mesorectal region was manually delineated on pre⁃treatment CT images. Handcrafted features and deep learning features were extracted using Pyradiomics and a pre⁃trained ResNet18 model, respectively. Feature selection was performed using univariable Logistic regression, Spearman correlation analysis, least absolute shrinkage and selection operator regression, and recursive feature elimination. Logistic regression, support vector machine, light gradient boosting machine, and eXtreme gradient boosting were employed to develop independent radiomics models （Rad⁃model）, independent models based on deep learning features （DL⁃model）, and the combined model integrating both feature sets （DLRad⁃model）. The predictive performance of the models was evaluated using the area under the curve (AUC) of receiver operating characteristic. Results The incidence of grade 2 or higher radiation proctitis did not differ significantly between the training set and the validation set (36.81% vs 25.96%, P=0.056). Both the DL⁃model and the DLRad⁃model constructed based on eXtreme gradient boosting achieved AUC of 0.901 (95%CI: 0.874-0.927) and 0.918 (95%CI: 0.893-0.940), respectively, in the training set. In the validation set, these models achieved AUC of 0.747 (95%CI: 0.644-0.845) and 0.729 (95%CI: 0.620-0.829), respectively. Both of which were significantly higher than that of the Rad⁃model (all P<0.05). However,  the difference in AUC between the DL⁃model and the DLRad⁃model was not statistically significant (P>0.05). Conclusions Deep learning features demonstrate advantages in predicting the risk of radiation proctitis after nCRT in patients with LARC, and providing an effective tool for clinical risk stratification. Related Articles | Metrics

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Efficacy of a high-risk factor quantitative questionnaire and immune fecal occult blood test in colorectal cancer screening GAO Yanhong, YU Miao, DONG Lifeng, DAI Miaoke, LI Jun 2025, 17 (5):  576-581.  doi: 10.3969/j.issn.1674-5671.2025.05.08 Abstract ( 17 )   PDF (596KB) ( 1 )   Save Objective To compare the efficacy of the high⁃risk factor questionnaire (HRFQ) and the immune fecal occult blood test (iFOBT) in colorectal cancer screening, and to provide evidence for optimizing early screening strategies. Methods A cross⁃sectional study design was adopted, involving participants scheduled for colonoscopy from Beijing between June 2024 and March 2025. The diagnostic efficacy of HRFQ and iFOBT, both individually and in combination, for detecting colorectal tumors was assessed, using colonoscopy and pathological results serving as the gold standard for evaluation.  Results A total of  920 participants were recruited, with 655 completing the HRFQ，and the high⁃risk rate was 41.98% (275/655). Among these, 557 underwent colonoscopy, resulting in an overall colorectal tumor detection rate of 47.22% (263/557). The HRFQ high⁃risk group (n=243) demonstrated a higher colorectal tumor detection rate than the low⁃risk group (n=314) (54.73% vs 41.40%, P=0.002), the non⁃advanced adenoma detection rate was also higher in the high⁃risk group (35.80% vs 27.07%， P=0.027), whereas no significant differences were observed in the detection rates of advanced adenoma or colorectal cancer. Among the 571 participants who completed iFOBT testing, the positive rate was 25.74% (147/571). Among these, 517 underwent colonoscopy，and the iFOBT⁃positive group （n=133） showed significantly higher detection rates for overall colorectal tumor (60.90% vs 42.96%，  P<0.001) , advanced adenoma （22.56% vs 8.60% ， P<0.001） and colorectal cancer （18.05% vs 0.78%， P<0.001） compared to the iFOBT⁃negative group （n=384）. In serial testing (HRFQ high⁃risk and iFOBT positive), the colorectal cancer detection rate reached 16.92%（11/65）. In parallel testing , the detection rates for both colorectal cancer and non⁃advanced adenoma in the HRFQ high⁃risk or iFOBT positive screening mode were elevated compared to the HRFQ low⁃risk or iFOBT negative screening mode (8.94% vs 0， 31.79% vs 9.77%， P<0.001), while the detection rate of non⁃neoplastic lesions decreased (45.36% vs 80.46%, P<0.001). The sensitivity, specificity and overall accuracy of HRFQ in the diagnosis of colorectal tumors were 50.57%, 62.59% and 56.91%, respectively; and those of iFOBT were 32.93%, 80.81% and 50.03%, respectively; the parallel screening (HRFQ high⁃risk or iFOBT positive) yielded 79.71%, 55.81% and 65.38%, respectively. The sensitivity of HRFQ or iFOBT individually and in combination (HRFQ high⁃risk or iFOBT positive) for colorectal cancer screening was 50.00%, 88.89% and 100.00%, respectively. Conclusions HRFQ is suitable for initial screening of non⁃advanced adenomas, while iFOBT demonstrates greater advantage in detecting advanced lesions. The integration  of both methods significantly enhances the sensitivity of colorectal tumor screening, particularly for advanced lesions, thereby optimizing optimizes screening efficiency and providing a new strategy for early colorectal cancer screening. Related Articles | Metrics

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Auxiliary diagnostic value of serum chitinase-3-like protein 1 levels in hepatitis B virus-related hepatocellular carcinoma LIN Ziyi, JIANG Yanji, LIN Qiuling, WEI Xiaoxia, ZHOU Zihan, MA Yingying, LIN Biaoyang, YU Hongping, LIANG Xiumei 2025, 17 (5):  582-589.  doi: 10.3969/j.issn.1674-5671.2025.05.09 Abstract ( 9 )   PDF (623KB) ( 1 )   Save Objective To investigate the auxiliary diagnostic value of serum chitinase⁃3⁃like protein 1 (CHI3L1) in hepatitis B virus (HBV)⁃related hepatocellular carcinoma (HCC). Methods A total of 654 patients with HBV⁃related HCC, 408 patients with chronic hepatitis B (CHB), and 551 apparently healthy individuals (AHC) were enrolled. The levels of serum CHI3L1, alpha⁃fetoprotein (AFP), alpha⁃fetoprotein variant L3 (AFP⁃L3), and des⁃γ⁃carboxy prothrombin prothrombin (DCP) were quantified. Receiver operating characteristic (ROC) curves were plotted. The sensitivity, specificity, and area under the curve (AUC) were used to determine the anxiliary diagnostic value of each serum biomarker in identifying HBV⁃related HCC. Results The levels of serum CHI3L1 (156.16 ng/mL), AFP (125.29 ng/mL), AFP⁃L3 (14.96 ng/mL), and DCP (359.75 ng/mL) were significantly elevated in the HCC group compared to the CHB and AHC groups (all P<0.001). In the context of  auxiliary diagnosis for HBV⁃related HCC, early⁃stage HCC, and small HCC using individual biomarkers, AFP yielded the highest AUC among the four biomarkers. Nevertheless, the diagnostic efficacy was significantly improved when AFP combined with AFP⁃L3, DCP, and CHI3L1. For HBV⁃related HCC patients who are AFP⁃negative (<20 ng/mL), the supplementary diagnostic efficacy of the combination of CHI3L1 and DCP (AHC control group : AUC=0.938; CHB control group : AUC=0.878)  outperformed individual biomarkers ( AHC control group: CHI3L1 AUC=0.888, DCP AUC=0.763; CHB control group: CHI3L1 AUC=0.769, DCP AUC=0.789). Conclusions The integration of CHI3L1 and commonly clinical biomarkers (AFP, AFP⁃L3, DCP) can significantly enhances the auxiliary diagnostic efficacy for HBV⁃related HCC, with particularly demonstrating critical value for early⁃stage HCC, small HCC, and AFP⁃negative cases. Related Articles | Metrics

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Network analysis of core symptoms and symptom clusters in breast cancer patients undergoing ovarian function suppression therapy CHEN Yunyun, LI Yuan, WU Qing, FANG Qiong 2025, 17 (5):  590-597.  doi: 10.3969/j.issn.1674-5671.2025.05.10 Abstract ( 10 )   PDF (1233KB) ( 0 )   Save Objective To investigate the symptom clusters, interrelationships among symptoms, and core symptoms in breast cancer patients undergoing ovarian function suppression (OFS) therapy, with the objective of establishing a theoretical foundation for precise symptom management. Methods Convenience sampling was used to select 1,132 breast cancer patients who received OFS therapy at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from October 2023 to July 2024. General information questionnaire and symptom burden scale were used for the investigation. Exploratory factor analysis was employed to identify symptom clusters, and R language was used to construct the symptom network to analyze indicators of symptom strength (rs), closeness (rc), and betweenness (rb). Results The most common symptoms among breast cancer patients undergoing OFS therapy were hot flashes（98.1%）, anxiety mood （97.9%）, and irritability （97.8%）. Ten distinct symptom clusters were identified: psychological, musculoskeletal, sexual, skin, sleep, nervous, somatic, vasomotor, vaginal, and gastrointestinal. Symptom network analysis showed that the top three symptoms by strength were vaginal dryness (rs=1.265), hot flashes (rs=1.232), and night sweats (rs=1.204); the top three by closeness were night sweats (rc=0.00210), hot flashes (rc=0.00204), and myalgia (rc=0.00195); and the top three by betweenness were night sweats (rb=93.000), hot flashes (rb=77.000), and vaginal dryness (rb=63.000).  Conclusions Vaginal dryness, hot flashes, and night sweats are identified as core symptoms within the symptom network of breast cancer patients undergoing OFS therapy. It is recommended that healthcare professionals closely monitor the changes in these symptoms and implement targeted interventions based on the characteristics of symptom clusters and the network influence of core symptoms, so as to enhance symptom management outcomes. Related Articles | Metrics

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Clinicopathological analysis of duodenal-type follicular lymphoma and literature review ZHOU Jing, LI Jun, LI Hui, LI Min 2025, 17 (5):  598-603.  doi: 10.3969/j.issn.1674-5671.2025.05.11 Abstract ( 18 )   PDF (926KB) ( 3 )   Save Objective To investigate the clinicopathological characteristics of duodenal⁃type follicular lymphoma (FL) and enhance awareness and diagnostic accuracy among clinicians and pathologists. Methods Analyzed the 15 cases of duodenal⁃type FL and reviewed pertinent literature to summarize the clinical manifestations, endoscopic features, pathological characteristics, and diagnosis essentials. Results This clinically atypical condition is typically an incidental endoscopic finding, with lesions primarily in the descending duodenum. Endoscopically, they appeared as white granular or nodular lesions (diameter range: 0.1-1.0 cm), with one polypoid case. Histologically, lesions were well⁃defined, exhibited expansile nodules of germinal centers within the mucosa and submucosa. The germinal centers were composed predominantly of centrocytes with scant centroblasts, showing low⁃grade follicular lymphoma (FL). Immunohistochemistry revealed diffuse BCL⁃2 expression in abnormal follicles, consistent with classic FL. Fluorescence in situ hybridization demonstrated t (14;18)(q32;q21) translocation. Next⁃generation sequencing revealed abnormal alterations in genes such as BCL⁃2, KMT2C, MET, CREBBP, BCL7A and IDH2. With a median follow⁃up of 18 months, all patients remained progression⁃free without chemotherapy, with spontaneous regression observed in 3 cases. Conclusion Duodenal⁃type FL exhibits a unique clinicopathological features, typically presenting as granular duodenal lesions, low⁃grade histology, and a favorable prognosis.  Related Articles | Metrics

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Metformin mediates the AMPK/KIF1B signaling pathway to suppress metastasis in bladder cancer cells LIU Ben, WEN Tianbin, HUANG Fei, ZHA Mingyong, WANG Qi, TANG Yong 2025, 17 (5):  604-612.  doi: 10.3969/j.issn.1674-5671.2025.05.12 Abstract ( 18 )   PDF (2735KB) ( 8 )   Save Objective To investigate the effect of metformin （MET） in bladder cancer cell metastasis and its regulation on adenosine monophosphate activated protein kinase (AMPK)/kinesin family member 1B (KIF1B) signaling pathway. Methods The effects of MET on the proliferation and migration of bladder cancer cell lines SW780, RT4, and UMUC3 were evaluated using the CCK⁃8 assay and real time cellular analysis (RTCA). The protein expression levels of AMPK/P⁃AMPK, mTOR, AKT/P⁃AKT, and KIF1B in MET⁃treated bladder cancer cells were analyzed via Western blot. Additionally, a lung metastasis model was established in C57BL/6J mice using MB49 cells to assess the intervention effects of MET on the metastasis process in vivo, along with its regulation of AMPK and KIF1B expression. Results MET was found to reduce the proliferation of various bladder cancer cell lines in a concentration⁃dependent manner, with median inhibition concentration （IC50） values of (26.0±1.4) mmol/L, (32.9±5.3) mmol/L, and (20.0±3.4) mmol/L for SW780, RT4, and UMUC3 cell lines, respectively. Treatment with MET at concentrations of 5 mmol/L for 72 hours significantly inhibited the migration of SW780 and UMUC3 cells (all P<0.05). When MET administration upregulated P⁃AMPK protein expression and downregulated KIF1B, AKT, and mTOR protein expression in RT4 and UMUC3 cells. Animal experiments further corroborated MET significantly delayed the formation time of tumor [(34.5±8.3) d vs (24.8±3.7) d， P<0.05）] and the median survival time of mice （40 d vs 28 d， P=0.016）. In addition, the protein expression of P⁃AMPK increased and KIF1B decreased in the lung tissue of lung metastasis mouse models (all P<0.05). Conclusions MET effectively inhibits the metastasis of bladder cancer cells both in vitro and in vivo. This mechanism may involve the activation of the AMPK pathway, which subsequently downregulates the expression of KIF1B, suggesting that the AMPK/KIF1B signaling pathway plays an important role in the MET⁃induced inhibition of bladder cancer metastasis. Related Articles | Metrics

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Impact of C. leadbetteri on the proliferation,invasion and migration of Cal27 tongue squamous cell carcinoma cell line YU Miaomiao, ZHANG Chunyan, YUAN Rongtao, GUAN Zhihui, GONG Luyang, WANG Qimin, CHEN Hang, GUO Qingyuan, WANG Lili, ZHOU Jianhua 2025, 17 (5):  613-618.  doi: 10.3969/j.issn.1674-5671.2025.05.13 Abstract ( 20 )   PDF (982KB) ( 1 )   Save Objective To investigate the impact of Capnocytophaga leadbetteri (C. leadbetteri ), isolated from tissues of patients with tongue squamous cell carcinoma (TSCC), on the proliferation, invasion, and migration of TSCC Cal27 cell line. Methods The C. leadbetteri strain n95, previously isolated and cultured by our research group from the tumor tissue of TSCC patients, were identified through revival culture, colony morphology observation, Gram staining, 16S rRNA sequencing analysis, and phylogenetic tree construction. Cal27 cells were infected with C. leadbetteri n95 suspension (CAL27⁃C. L group), while uninfected Cal27 cells (CAL27 group) served as the control. Adhesion counts of cells and bacterial were recorded 2 h post⁃infection. The proliferative capacity of Cal27 cells at different multiplicity of infection (MOI=0, 10, 25) and time points (0, 24, 48, 72 h) was assessed using the CCK⁃8 assay. Transwell assays were employed to evaluate the migration and invasion capabilities of cells. Results Based on 16S rRNA sequences alignment, which exhibits a 99.63% sequence identity with the reference strain H6253, and Neighbour⁃Joining phylogenetic tree, strain n95 was identified as C. leadbetteri. Cell adhesion assays demonstrated that the adhesion index of C. leadbetteri n95 to Cal27 cells was 1.62±0.57. The CCK⁃8 assay results demonstrated that the proliferation activity of Cal27 cells was significantly enhanced  (P<0.05) after 24 h of infection with C. leadbetteri n95 at an MOI of 10∶1 . Transwell assays revealed that the invasion and migration capabilities of the CAL27⁃C. L group were significantly enhanced compared to the CAL27 group (P<0.01). Conclusions C. leadbetteri n95, isolated from TSCC, effectively adheres to Cal27 cells and markedly boots their proliferation, migratory and invasive capacities under in vitro. 【Key words】 Tongue squamous cell carcinoma; C. leadbetteri; Proliferation; Migration; Invasion Related Articles | Metrics

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Impact of puerarin on malignant biological behaviour of nasopharyngeal carcinoma cells and its underlying molecular mechanisms#br# LIN Hanxin, LUO Xuewen, ZHANG Chunyu, LIU Xinghui, ZHAO Wei 2025, 17 (5):  619-626.  doi: 10.3969/j.issn.1674-5671.2025.05.14 Abstract ( 19 )   PDF (2522KB) ( 6 )   Save Objective To investigate the impact of puerarin on the proliferation, migration, invasion, and epithelial⁃mesenchymal transition (EMT) in nasopharyngeal carcinoma cells, as well as to elucidate its potential mechanism. Methods Nasopharyngeal carcinoma 5⁃8F and HK⁃1 cells were exposed to varying concentrations of puerarin to identify the optimal concentration for intervention using the CCK⁃8 assay. The cells were divided into the negative control group and the puerarin group, receiving their respective treatments. Cycle progression was assessed by flow cytometry, cell migration was assessed via a scratch assay, and cell invasion was evaluated using a Transwell assay. Western blot and immunofluorescence assays were conducted to quantify the expression of proteins associated with the EMT process and the PI3K/AKT/mTOR signaling pathway. Furthermore, 5⁃8F and HK⁃1 cells were co⁃treated with the PI3K activator 740Y⁃P and puerarin, followed by Western blot analysis to detect the expression of proteins related to the PI3K/AKT/mTOR signaling pathway. The effects of puerarin on tumour cell proliferation were validated via CCK⁃8 assays, and clonogenic assays. Results The viability of nasopharyngeal carcinoma 5⁃8F and HK⁃1 cells was significantly reduced (all P<0.0001) upon exposure to varying concentrations (200-1,600 μmol/L) of puerarin, exhibiting a dose⁃dependent effect. Compared with the control group, puerarin at concentrations of 800 μmol/L and 1,200 μmol/L significantly suppressed the proliferation, migration, and invasion capabilities of nasopharyngeal carcinoma 5⁃8F and HK⁃1 cells (all P<0.001). Additionally, puerarin treatment resulted in cell cycle at the G0/G1 phase (all P<0.05), enhanced the protein expression levels of the epithelial marker E⁃cadherin, and reduced the protein expression levels of the mesenchymal markers N⁃cadherin and vimentin. Puerarin downregulated the expression of PI3K, AKT, mTOR and their phosphorylated forms, whereas the PI3K activator 740Y⁃P reversed the puerarin⁃induced changes in phosphorylation levels of PI3K, AKT and mTOR, and attenuated  the inhibitory effect of puerarin on nasopharyngeal carcinoma cell proliferation (all P<0.01).  Conclusions Puerarin inhibits the proliferation, migration, invasion, and EMT in nasopharyngeal carcinoma 5⁃8F and HK⁃1 cell lines, possibly by modulating the PI3K/AKT/mTOR signaling pathway.  Related Articles | Metrics

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Multi-omics characteristics of BEND3 in breast cancer and its role in promoting proliferation and metastasis ZHANG Xiaoyan, CUI Haiyan, GOU Yuting, LI Yongxiang, WANG Yiyang, GUO Chenming 2025, 17 (5):  627-339.  doi: 10.3969/j.issn.1674-5671.2025.05.15 Abstract ( 18 )   PDF (4328KB) ( 1 )   Save Objective To investigate the multi⁃omics characteristics of BEN domain containing 3(BEND3 ) in breast cancer and its effect on tumor cell proliferation, migration, and invasion. Methods BEND3 mRNA and protein expression were analyzed for prognostic value using the TCGA, GTEx, and GEO, UALCAN and HPA database, A total of 48 paired breast cancer and adjacent tissues samples from The First Affiliated Hospital of Xinjiang Medical University (August 2023 to July 2024) were collected for immunohistochemistry. Prognostic significance was assessed with univariable and multivariable Cox regression and Kaplan⁃Meier analyses, validated by PrognoScan and Kaplan⁃Meier Plotter. Genetic mutations, copy number variations, and methylation status were examined using the cBioPortal and GSCA. Immune cell infiltration was assessed via TIMER2.0, and a protein⁃protein interaction (PPI) network was constructed using STRING, followed by GO, KEGG, and GSEA enrichment analyses. BEND3 knockdown and overexpression in MCF⁃7 and MDA⁃MB⁃231 cell lines were verified by qRT⁃PCR and Western blot. Subsequently, cell proliferation, migration, and invasion were evaluated using CCK⁃8 assay, clolny formation assay wound healing assay, and Transwell assays, respectively. Results BEND3 mRNA and protein levels were significantly elevated in breast cancer (P<0.001), particularly in the Basal and triple⁃negative subtypes (all P<0.001). It exhibited moderate diagnostic value for breast cancer (AUC=0.820) and was linked to poor  overall survival, disease⁃specific survival and progression⁃free interval (all P<0.05), serving as an independent prognostic risk factor for breast cancer (P<0.05). BEND3 expression was influenced by gene amplification, copy number variation, and DNA and RNA methylation, and was correlated with immune cell infiltration, tumor mutational burden and neoantigen load. Functional enrichment analysis revealed that it was involved in cell cycle and Notch signaling, as well as metabolic reprogramming. In vitro, BEND3 overexpression enhanced breast cancer cell proliferation, migration, and invasion, while knockdown inhibited these effects (all P<0.05). Conclusions BEND3 is markedly overexpressed in  breast cancer and is modulated by genetic and epigenetic alterations, associated with poor prognosis and the tumor immune microenvironment. The elevated expression of BEND3 facilitates the proliferation, migration, and invasion in  breast cancer cell. Related Articles | Metrics

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Research progress on lactylation in hepatocellular carcinoma CHEN Mengmeng, CHEN Nan, XUE Junjie, FENG Lei 2025, 17 (5):  640-646.  doi: 10.3969/j.issn.1674-5671.2025.05.16 Abstract ( 22 )   PDF (408KB) ( 2 )   Save  Hepatocellular carcinoma (HCC) is the predominant type of primary liver cancer, with the majority of  patients being diagnosed at intermediate to advanced stages, resulting in a poor prognosis. Lactylation, a novel post⁃translational modification (PTM) driven by cellular metabolism, plays a pivotal role in regulating oncogene expression, driving metabolic reprogramming, and shaping the immunosuppressive tumor microenvironment (TME) by modifying histones and key effector proteins. Research has demonstrated that lactylation exhibits significant potential in HCC diagnosis, prognostic assessment, and targeted therapy. The combination of anti⁃lactylation regulation and immunotherapy may further enhance the efficacy of HCC treatment. Lactylation serves not only as a potential biomarker for HCC diagnosis and prognosis prediction, but also provide promising new targets for drug development through its key nodes within the regulatory network. This review summarizes the generation and functions of lactylation, its mechanisms in driving HCC malignant progression, and its potential applications in HCC diagnosis and treatment. Related Articles | Metrics

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Research advances on factors influencing and intervention strategies for time toxicity in advanced cancer patients#br# ZHANG Jiazhuo, LYU Liming, WANG Yajun, LIN Shunan 2025, 17 (5):  647-652.  doi: 10.3969/j.issn.1674-5671.2025.05.17 Abstract ( 20 )   PDF (408KB) ( 1 )   Save Time toxicity refers to the temporal burden endured by cancer patients during medical activities such as diagnosis, treatment, and rehabilitation management. It typically persists throughout the disease period and is particularly pronounced in advanced cancer patients. Time toxicity can severely compromise treatment efficacy and quality of life, potentially offsetting the survival benefits gained from therapy. In recent years, with an increasing emphasis on personalized treatment approaches, growing research has focused on time toxicity, advocating for its inclusion as a decision⁃making indicator in clinical care and nursing protocols. This article provides a systematic review of assessment methods, influencing factors, adverse effects, and intervention strategies for time toxicity in advanced cancer patients, aiming to offer a reference for further research. Related Articles | Metrics