Far Eastern Memorial Hospital

Gastric cancer (GC) remains a global health burden. While international guidelines share consensus, variations exist in disputed issues. The 2025 Taiwan Consensus and Management Guidelines for Gastric Cancer had just been released. We compared the key recommendations with established international guidelines. A multidisciplinary taskforce addressed key questions and recommendations using modified Delphi method and evidence-based approaches. The comparative review aimed to elucidate similarities and differences among guidelines from Taiwan, Japan, South Korea, China, Europe, and the US. Guidelines converge on absolute endoscopic resection criteria for early GC but differ in extended indications and perioperative approaches for locally advanced disease. Heterogeneity exists in biomarker assessment protocols, cutoff thresholds, and companion diagnostics. For metastatic disease, consensus exists on anti-HER2, anti-VEGF, immunotherapy, and biomarker-driven strategies, though oligo-metastatic definitions and intraperitoneal chemotherapy indications remain controversial. Optimal GC management requires integrating global evidence with regional contexts. The comparative review addresses heterogeneity among international guidelines, which helps harmonize management strategies as therapeutic standards evolve.

Albumin, a highly biocompatible protein, has been utilized in the construction of anti-cancer drugs for the treatment of various cancers. However, albumin-based nanomedicines still face several clinical challenges, including low stability in the bloodstream, non-specific targeting ability, and lack of controlled release capability. To address these limitations, we developed a multiprotein-based nanomedicine for targeted chemotherapy of non-small cell lung cancer (NSCLC). This nanomedicine was assembled using a heart-shaped albumin and two Y-shaped anti-CD44 and anti-CD133 antibodies. To enhance stability and improve therapeutic efficacy, the multiproteins were crosslinked using disulfide bond linkers and loaded with paclitaxel and ceramide. This resulted in nanomedicines that exhibited responsiveness to glutathione (GSH) and demonstrated inhibition of tumor cancer cells and cancer stem cells (CSCs). Our experimental results indicated that the inclusion of anti-CD44 and anti-CD133 antibodies enhanced the targeting capability of nanomedicines towards cancer cells and CSCs in an in vitro study and the accumulation in both normoxic regions and hypoxic niches in in vivo tumor xenografts. The multiprotein-based nanomedicines also demonstrated GSH-dependent drug release behavior, induced apoptosis in cancer cells and CSCs, inhibited cell migration, and effectively suppressed NSCLC tumor growth. Overall, our findings presented a novel nanostructure created from differently shaped proteins for application in drug delivery. This multiprotein-based nanomedicines showed promising potential in addressing the limitations of albumin-based nanomedicines and may offer improved therapeutic outcomes for cancer treatment.

Bronchiectasis has traditionally been characterized as a neutrophil-driven disease, yet emerging evidence suggested inflammatory heterogeneities. The prognostic significance of elevated serum immunoglobulin E (IgE) in patients without peripheral eosinophilia remains unclear. We conducted a multicenter prospective cohort study between 2017 and 2020 across 16 institutions in Taiwan. Individuals with bronchiectasis but without allergic bronchopulmonary aspergillosis were included. Patients were stratified by baseline absolute eosinophil count (cutoff 300 /uL) and serum IgE level (≤ 100, 100–500, > 500 IU/mL). The primary endpoint was severe exacerbations resulting in hospitalization at one year. Secondary endpoints included all-cause mortality, distribution of sputum pathogen, imaging pattern, and lung function. A total of 579 individuals were enrolled. Nontuberculous mycobacteria (10.7

BACKGROUND:Staging of oral squamous cell carcinoma (OSCC) does not account for anatomical subsites. However, these subsites demonstrate considerable pathological heterogeneity and survival differences. Most prior studies have not systematically examined the influence of distinct pathological factors across subsites. Therefore, this study aimed to evaluate the clinical and pathological characteristics, as well as survival outcomes of OSCC across major oral subsites, using a nationwide cancer registry. METHODS:A total of 17,118 patients with surgically treated OSCC diagnosed between 2018 and 2022 were identified from the Taiwan Cancer Registry. Pathological factors-including perineural invasion (PNI), lymphovascular invasion (LVI) and extranodal extension (ENE)-were analyzed across four major oral subsites (tongue, buccal mucosa, gum, and others). Multivariable logistic regression was used to assess the associations between pathological factors and subsites. Survival analyses were performed using life table methods with Kaplan-Meier plots and Cox regression analysis to estimate overall survival (OS) and disease-specific survival (DSS). RESULTS:Adverse pathological features-including PNI, LVI, and ENE-showed varied distributions across OSCC subsites. After adjusting for gender, age, and tumor status, tongue cancer was associated with higher odds of adverse pathological factors: OR 1.76 (95% CI: 1.56-1.98) for PNI, OR 1.34 (95% CI: 1.17-1.53) for LVI, and OR 1.21 (95% CI: 1.08-1.35) for ENE. Notably, despite these aggressive pathological features, tongue tumors were associated with superior survival outcomes (5-year OS: 66%, 95% CI: 65-69%) compared to other subsites (5-year OS: 63%, 95% CI: 61-66%). CONCLUSIONS:PNI, LVI and ENE status showed distinct distributions among OSCC subsites, highlighting the need for tailored prognostic assessment according to subsites of OSCC and individualized management strategies.