Background:Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive tumor with a poor prognosis, despite the emergence of chemotherapies such as gemcitabine plus albumin-bound paclitaxel (nab-paclitaxel, AG), unmet medical needs still exist for patients with metastatic PDAC (mPDAC). Surufatinib is a small-molecule tyrosine kinase inhibitor targets vascular endothelial growth factor (VEGFR) 1, 2, 3, fibroblast growth factor receptor 1 (FGFR1), and colony stimulating factor 1 receptor (CSF-1R). This single-center, retrospective study evaluates the potential efficacy of combination therapy containing Surufatinib in advanced or metastatic pancreatic cancer. Method:We conducted a real world retrospective study of mPDAC patients who received the Surufatinib between July 2022 and July 2023 at Zhejiang Cancer Hospital. In addition, patients who received first line chemotherapy at the same period were analyzed as comparison. Result:As of November 20, 2024, 20 eligible patients were identified in this retrospective study. The median progression-free survival (mPFS) of patients who received Surufatinib treatment was 5.27 months (95% CI, 2.55-7.98), and the median overall survival(mOS) was 9.93 months (95% CI,6.55-13.32). For fist line treatment, 9 patients received Surufatinib combined with immune checkpoint inhibitors (ICIs) and chemo and the mPFS was 7.5 months (95% CI, 3.14-11.85), compared with an mPFS of 5.43 months (95% CI, 3.89-6.96) for 52 mPDAC patients received chemotherapy at the same period. Grade 3 or above Treatment Related Adverse Event (TRAE) were neutrophil count decreased (10%), and white blood cell count decreased (5%). Conclusion:Preliminary data suggest that surufatinib shows potential therapeutic benefit in mPDAC, but its efficacy needs to be further validated. This combination strategy may provide a new treatment option for patients, especially in the first-line setting. Future studies will expand the sample size and include additional evaluation parameters to fully assess its efficacy and safety. Clinical trial registration:ClinicalTrials, identifier NCT06378580.

BACKGROUND:Accurate prediction of response to neoadjuvant chemoradiotherapy (nCRT) is very important for treatment plan decision in locally advanced rectal cancer (LARC). The aim of this study was to investigate whether self-attention mechanism based multi-sequence fusion strategy applied to multiparametric magnetic resonance imaging (MRI) based deep learning or hand-crafted radiomics model construction can improve prediction of response to nCRT in LARC.METHODS:This retrospective analysis enrolled 422 consecutive patients with LARC who received nCRT before surgery at two hospitals. All patients underwent multiparametric MRI scans with three imaging sequences. Tumor regression grade (TRG) was used to assess the response of nCRT based on the resected specimen. Patients were separated into 2 groups: poor responders (TRG 2, 3) versus good responders (TRG 0, 1). A self-attention mechanism, namely channel attention, was applied to fuse the three sequence information for deep learning and radiomics models construction. For comparison, other two models without channel attention were also constructed. All models were developed in the same hospital and validated in the other hospital.RESULTS:The deep learning model with channel attention mechanism achieved area under the curves (AUCs) of 0.898 in the internal validation cohort and 0.873 in the external validation cohort, which was the best performed model in all cohorts. More importantly, both the deep learning and radiomics model that applied channel attention mechanism performed better than those without channel attention mechanism.CONCLUSIONS:The self-attention mechanism based multi-sequence fusion strategy can improve prediction of response to nCRT in LARC.

结直肠黏液性腺癌是结直肠癌(colorectal cancer,CRC)中的一个独特亚型,其特征是细胞外黏液丰富,占肿瘤体积的50％以上.结直肠黏液性腺癌在结直肠癌患者中占10％–20％,多见于女性和年轻患者.此外,结直肠黏液性腺癌常见于近端结肠,通常在晚期被诊断出来.基于其分子背景,结直肠黏液性腺癌与黏蛋白2(mucin 2,MUC2)和黏蛋白5AC(mucin 5AC,MUC5AC)的过表达有关.同时,RAS/MAPK和PI3K/Akt/mTOR通路的关键基因突变率较高.结直肠黏液性腺癌的微卫星不稳定性(microsatellite instability,MSI)也高于结直肠非黏液性腺癌,这可能与Lynch综合征和CpG岛甲基化现象相关.结直肠黏液性腺癌与结直肠非黏液性腺癌的预后尚存争议.此外,需要对结直肠黏液性腺癌患者的姑息或辅助化疗的反应损伤进行更多的研究,以提供特殊治疗.本文探讨了结直肠黏液性腺癌的分子机制和组织病理学特点,并根据最近文献对其预后和治疗方法提出最新建议.

Mucinous colorectal adenocarcinoma is a distinct subtype of colorectal cancer (CRC) characterized by the presence of abundant extracellular mucin which accounts for at least 50% of the tumor volume. Mucinous colorectal adenocarcinoma is found in 10%–20% of CRC patients and occurs more commonly in female and younger patients. Moreover, mucinous colorectal adenocarcinoma is more frequently located in the proximal colon and diagnosed at an advanced stage. Based on its molecular context, mucinous colorectal adenocarcinoma is associated with the overexpression of mucin 2 (MUC2) and mucin 5AC (MUC5AC) proteins. At the same time, it shows higher mutation rates in the fundamental genes of the RAS/MAPK and PI3K/Akt/mTOR pathways. Mucinous colorectal adenocarcinoma also shows higher rates of microsatellite instability (MSI) than non-mucinous colorectal adenocarcinoma which might correlate it with Lynch syndrome and the CpG island methylator phenotype. The prognosis of mucinous colorectal adenocarcinoma as to non-mucinous colorectal adenocarcinoma is debatable. Further, the impaired responses of mucinous colorectal adenocarcinoma to palliative or adjuvant chemotherapy warrant more studies to be performed for a specialized treatment for these patients. In this review, we discuss the molecular background and histopathology of mucinous colorectal adenocarcinoma, and provide an update on its prognosis and therapeutics from recent literatures.

Aim: This study analyzed clinicopathological features of colorectal mucinous carcinoma and their prognostic values. Patients & method: This study enrolled 265 patients with mucinous colorectal cancer. Clinicopathological information and prognosis were reviewed retrospectively. Kaplan-Meier method, log- rank test and COX proportional hazard regression models were used. Results: In postoperative mucinous carcinoma patients (median age 56, 119 [44.9%] female), advanced tumor stage (odds ratio [OR]: 2.378; 95% CI: 1.512-3.741; p = 0.0002), poor differentiation (OR: 1.896; CI: 1.217-2.955; p = 0.0047) and right-sided tumors (OR: 2.421; CI: 1.145-5.102; p = 0.0206) were associated with shorter overall survival. Appendiceal/ileocecal cecal tumors were not different for prognosis. Conclusion: Mucinous colorectal carcinoma exhibits distinct tumor characteristics. Poor differentiation, advanced stage at presentation and the right side serve as negative prognostic factors.

Triple negative breast cancer (TNBC) accounts for approximately 15-20% of all breast cancer cases and is usually more aggressive with a poorer clinical outcome compared with other breast cancer subtypes. Evidence of the involvement of microRNAs (miRNAs) in cancer has provided an opportunity for the development of novel effective therapeutic targets in TNBC. In the present study, the miRNA expression profiles of the human breast cancer cell line, MDA-MB-231, and MCF-7 cells, was evaluated by using miRNA microarray analysis. A total of 107 differentially expressed miRNAs (57 upregulated and 50 downregulated) were identified in MDA-MB-231 cells compared with MCF-7 cells. Five prominently dysregulated miRNAs (miR-200c-3p, miR-221-3p, miR-222-3p, miR-192-5p and miR-146a) were further confirmed by reverse transcription-quantitative polymerase chain reaction. In addition, gene ontology analysis and pathway enrichment analysis revealed that the dysregulated miRNAs and predicted targets were found to be involved in the mitogen-activated protein kinase, Wnt, and transforming growth factor-β signaling pathways, which were known to contribute to TNBC progression and metastasis. Finally, miRNA gene network analyses suggested that miR-200c may serve as a crucial miRNA in breast cancer. Taken together, these findings may provide a comprehensive view of the function of aberrant miRNAs involved in TNBC, and dysregulated miRNAs hold promise as potential biomarkers and therapeutic targets for patients with TNBC.

Malignant tumors in the tonsils are usually primary. Metastases to the tonsils are extremely rare, with nearly one hundred cases reported. Herein we present an unusual case of palatine tonsillar metastasis of non-small cell lung cancer during chemotherapy. The patient was a 39-year-old man who was diagnosed as non-small lung cancer with IIIA4 staging and poor differentiated histology. After two cycles of vinorelbine and cisplatin based chemotherapy, a big mass was developed in the right palatine tonsil which was pathologically confirmed as the metastasis from the lung. There was no hemorrhage and complains except moderate foreign body sensations. No cervical lymphadenopathy and distal metastases to other organs such as brain and liver was found. Because of poor overall performance status, no radiotherapy was given. The disease progressed after docetaxel treatment. To the best of our knowledge, this is the first case with palatine tonsillar metastasis from non-small lung cancer during induction chemotherapy.

目的:评价螺旋CT(SCT)在直肠癌术前分期中的价值.方法:对58例直肠癌患者术前行SCT检查,与手术及病理结果对比,观察SCT对直肠肿瘤浸润深度、区域淋巴结转移和远处转移判断的准确性.结果:SCT术前分期总的准确率为65.5%(38/58),T分期的准确率为81.0%(47/58),N分期的准确率为67.2%(39/58),评价肿瘤侵犯外膜的敏感性和特异性分别为97.9%(46/47)和63.6%(7/11),评价淋巴结转移的敏感性为71.1%(27/38),特异性为60.0%(16/20).结论:SCT对直肠癌术前判断外膜侵犯、淋巴结转移和远处转移情况有重要价值.