Background Current bone metastasis evaluation relies on fragmented anatomic or metabolic criteria, often yielding discordant classifications. Purpose To develop Response Evaluation Criteria in Bone Metastases (termed RECIBM) and evaluate its performance against the University of Texas MD Anderson Cancer Center, PET Response Criteria in Solid Tumors (PERCIST), and European Organisation for Research and Treatment of Cancer (EORTC) criteria. Materials and Methods This retrospective study was conducted between October 2017 and September 2023. RECIBM was established based on multidisciplinary consensus and assessed on real-world patient data, with treatment responses evaluated using RECIBM, MD Anderson, PERCIST, and EORTC criteria. The paired subgroup comprised patients evaluable by all four criteria; the remaining patients underwent technetium 99m methylene diphosphonate bone scintigraphy only and were evaluable using the MD Anderson criteria and RECIBM. Agreement was quantified using the Cohen κ value, and prognostic performance for overall survival and bone progression-free survival was assessed using the Harrell C-index and multivariable Cox regression. Results Eighty-four patients (median age, 59.0 years [IQR, 52.0-68.3 years]; 59 male) were included. RECIBM-defined response classifications demonstrated high agreement with those of existing criteria (κ = 0.80-0.98; all P < .001) and reclassified 19% of patients (16 of 84). In the paired subgroup, RECIBM showed the highest C-index for overall survival (0.807 vs 0.771-0.782; P = .10-.14) and bone progression-free survival (0.849 vs 0.799-0.833; raw P = .03-.26; adjusted P = .088-.256), with no evidence of differences after adjustment. Subgroup analyses showed consistent performance across different imaging modalities and tumor types (P for interaction = .39 and .051, respectively). In multivariable analysis, RECIBM-defined response was associated with overall survival (hazard ratio, 0.07 [95% CI: 0.03, 0.19]; P < .001) and bone progression-free survival (hazard ratio, 0.03 [95% CI: 0.01, 0.08]; P < .001). Conclusion RECIBM-defined response classifications showed high agreement with established criteria, reclassified 19% of patients, and were associated with overall survival and bone progression-free survival. © RSNA, 2026 Supplemental material is available for this article. See also the editorial by Mohammadi and Guermazi in this issue.

Chromatin remodeling plays a pivotal role in the progression of esophageal squamous cell carcinoma (ESCC), but the precise mechanisms remain poorly understood. Here, we elucidated the critical function of staphylococcal nuclease and tudor domain-containing 1 (SND1) in modulating chromatin dynamics, thereby driving ESCC progression in both in vitro and in vivo models. Our data revealed that SND1 was markedly overexpressed in ESCC cell lines. Silencing SND1 disrupted histone modifications, attenuated RNA polymerase II activity, and precipitated increased chromosomal aberrations and DNA damage, particularly following camptothecin treatment. These molecular perturbations culminated in diminished cellular proliferation, metastasis, and chemoresistance. We further identified that the regulatory effects of SND1 on chromatin were mediated through its interaction with SMARCA5, a process potentiated by PIM1-catalyzed phosphorylation of SND1 at serine 426. This SND1-SMARCA5 interaction was essential for the transcriptional activation of CUX1, a key oncogene implicated in ESCC progression. Notably, disruption of SND1S426 phosphorylation impaired the SND1-SMARCA5 interaction, leading to significant inhibition of ESCC tumor growth and metastatic potential in vivo. Our findings unveil a novel mechanistic axis involving SND1 and SMARCA5 in chromatin remodeling and oncogenesis, offering promising therapeutic targets for ESCC intervention.

目的 报告1例滤泡树突状细胞肉瘤并发副肿瘤性天疱疮的临床表现及临床治疗,从而提高对该疾病多样临床表现的认识,避免误诊、漏诊的发生并完善相关诊治.方法 分析1例滤泡树突状细胞肉瘤并发副肿瘤性天疱疮的临床表现及临床治疗并查阅国内外文献资料.结果 此例是来自淋巴结外部的滤泡性树突状细胞肉瘤,因其细胞边界不清,明显的异型和有丝分裂而具有较高的肿瘤恶性程度,手术后患者的状态逐渐恶化.结论 对于局限性病变,手术切除是首选治疗方式.但单纯手术具有较高的局部复发率,巩固性放疗可降低手术患者的局部复发率,并延长其无病生存期.对全身播散性FDCS(多处淋巴结肿大)、有巨大肿块或手术未能根治的患者,需要进行有效的联合化疗.

LBA244 Background: Neoadjuvant chemotherapy or chemoradiotherapy followed by surgery is the standard of care for resectable locally advanced esophageal squamous cell carcinoma (LA-ESCC). However, recurrence post-surgery remains a concern. Recent single-arm studies with neoadjuvant camrelizumab plus chemotherapy showed promising results. This multicenter, randomized, open-label, phase III study aims to evaluate the role of neoadjuvant camrelizumab plus chemotherapy followed by adjuvant camrelizumab, versus neoadjuvant chemotherapy alone for resectable LA-ESCC. Methods: Patients with resectable thoracic LA-ESCC (T1b-3N1-3M0 or T3N0M0) were stratified according to clinical stage (I/II, III, or IVa) and randomized (1:1:1) to three groups for two 3-week cycles of neoadjuvant therapy. Group A received camrelizumab, albumin-bound paclitaxel and cisplatin; group B used camrelizumab, paclitaxel and cisplatin; group C received paclitaxel and cisplatin. Surgery was planned 4-6 weeks post-neoadjuvant therapy. Postoperative adjuvant camrelizumab every 3 weeks was given to groups A and B for up to 15 cycles. The co-primary endpoints were pathological complete response (pCR) rate, assessed by an independent blinded pathological committee, and event-free survival, evaluated by investigators per RECIST 1.1. The overall type I error was controlled at a one-sided 0.025 across the primary endpoints using a graphical method. Results: Between April, 2021, and August, 2023, we enrolled 391 patients: group A (n = 132), group B (n = 130), and group C (n = 129). 106 (27.1%), 279 (71.4%), 6 (1.5%) patients were in clinical stage I/II, III, and IVa. Tumors were located in the upper, middle, and lower thoracic esophagus for 41 (10.5%), 201 (51.4%), and 149 (38.1%) patients. 128 (97.0%), 125 (96.2%), and 122 (94.6%) patients from groups A, B, and C completed two cycles of neoadjuvant therapy, and 114 (86.4%), 116 (89.2%), and 103 (79.8%) underwent surgery. In the intention-to-treat population, the pCR rate was significantly higher in groups A (28.0%) and B (15.4%) compared to group C (4.7%) (group A vs. C: difference, 23.5%, 95%CI, 15.1-32.0; OR, 8.11, 95%CI, 3.28-20.06; two-sided P < 0.0001; group B vs. C: difference, 10.9%, 95%CI, 3.7-18.1; OR, 3.81, 95%CI, 1.48-9.80; two-sided P = 0.0034); major pathologic response rates were 59.1%, 36.2%, 20.9% for groups A, B and C. In the surgical set, the R0 resection rate was 99.1%, 95.7% and 92.2% for groups A, B and C, and the incidence of postoperative complications was 34.2%, 38.8% and 32.0%. During neoadjuvant treatment, the incidence of grade ≥3 treatment-related adverse events was 34.1%, 28.5% and 28.8%. Conclusions: In resectable LA-ESCC patients, neoadjuvant camrelizumab with chemotherapy showed superior pCR and a tolerable safety profile compared to neoadjuvant chemotherapy alone. Clinical trial information: ChiCTR2000040034 .

Recent single-arm studies involving neoadjuvant camrelizumab, a PD-1 inhibitor, plus chemotherapy for resectable locally advanced esophageal squamous cell carcinoma (LA-ESCC) have shown promising results. This multicenter, randomized, open-label phase 3 trial aimed to further assess the efficacy and safety of neoadjuvant camrelizumab plus chemotherapy followed by adjuvant camrelizumab, compared to neoadjuvant chemotherapy alone. A total of 391 patients with resectable thoracic LA-ESCC (T1b-3N1-3M0 or T3N0M0) were stratified by clinical stage (I/II, III or IVA) and randomized in a 1:1:1 ratio to undergo two cycles of neoadjuvant therapy. Treatments included camrelizumab, albumin-bound paclitaxel and cisplatin (Cam+nab-TP group; n = 132); camrelizumab, paclitaxel and cisplatin (Cam+TP group; n = 130); and paclitaxel with cisplatin (TP group; n = 129), followed by surgical resection. Both the Cam+nab-TP and Cam+TP groups also received adjuvant camrelizumab. The dual primary endpoints were the rate of pathological complete response (pCR), as evaluated by a blind independent review committee, and event-free survival (EFS), as assessed by investigators. This study reports the final analysis of pCR rates. In the intention-to-treat population, the Cam+nab-TP and Cam+TP groups exhibited significantly higher pCR rates of 28.0% and 15.4%, respectively, compared to 4.7% in the TP group (Cam+nab-TP versus TP: difference 23.5%, 95% confidence interval (CI) 15.1-32.0, P < 0.0001; Cam+TP versus TP: difference 10.9%, 95% CI 3.7-18.1, P = 0.0034). The study met its primary endpoint of pCR; however, EFS is not yet mature. The incidence of grade >= 3 treatment-related adverse events during neoadjuvant treatment was 34.1% for the Cam+nab-TP group, 29.2% for the Cam+TP group and 28.8% for the TP group; the postoperative complication rates were 34.2%, 38.8% and 32.0%, respectively. Neoadjuvant camrelizumab plus chemotherapy demonstrated superior pCR rates compared to chemotherapy alone for LA-ESCC, with a tolerable safety profile. Chinese Clinical Trial Registry identifier: ChiCTR2000040034.

Long noncoding RNAs (lncRNAs) contribute to esophageal squamous cell carcinoma (ESCC) progression, but the underlying mechanisms remain elusive. In this study, we verified a hitherto uncharacterized hypoxia-responsive lncRNA, G077640, which is upregulated in human ESCC cells and tissues, supporting the proliferation and migration of ESCC cells. Mechanistically, G077640 prevented hypoxia-inducible factor-1α (HIF1α) from being degraded by directly interacting with histone H2AX and further modulated the interaction of HIF1α and H2AX. In addition, G077640 reprogrammed glycolytic metabolism by regulating the expression of glucose transporter 4 (GLUT4), hexokinase 2 (HK2) and pyruvate dehydrogenase kinase 1 (PDK1) for ESCC proliferation and migration. Clinically, G077640 was associated with poor prognosis in ESCC patients. Taken together, our findings identified a hypoxia-responsive lncRNA that contributes to ESCC cells proliferation and migration, and targeting G077640 and its pathway might be a potential therapeutic strategy for ESCC.

Background:As a new surgical procedure for non-small cell lung cancer, single-port video-assisted thoracoscopic surgery (VATS) has lately gained popularity; nevertheless, it is unknown if single-port VATS offers any advantages over multi-portal. The study aims to assess the different impacts of using single-port VATS versus 2-port or multi-port VATS such as operation and drainage time, blood loss volume, number of resected lymph nodes, and hospital stay in lung cancer patients. Methods:Inclusion criteria included studies from different languages that compare single-port against 2 or multi-port VATS. The outcomes of these studies were analyzed using a random-effect model and it was used to calculate the mean difference with 95 percent confidence intervals to quantify the impact of different surgical techniques on clinical parameters. Results:Single or Uni-portal video-assisted thoracoscopic surgery results in significantly lower drainage time after surgery compared with 2-port (P = .03) and multi-port (P < .001) VATS. In contrast to the resection of lymph nodes, there was no significant difference between uni-port and 2-port (P = .49) or multiport (P = .29) VATS. While operation time, blood loss, complications, and hospital stay were significantly lower in uni-port compared with multi-port VATS (P = .04, P = .002, P < .001, respectively), but not with 2-port VATS (P = .44, 0.06, P = .13). There were no significant differences between uni-port and multi-port VATS regarding conversion rate, mortality, and staging. Conclusion:Single or Uni-portal video-assisted thoracoscopic surgery has high efficacy and lower side effects compared with multi-port regarding the perioperative outcomes. Two-port VATS has similar results with uni-port in several parameters.

Lung cancer is a malignant tumor disease with a high case fatality rate and increasing morbidity yearly. It is highly concealed, and cancer cells can metastasize at an early stage. The commonly used method for this is cryoablation, which can effectively treat Lewis lung cancer and has many advantages such as being minimally invasive, having a small impact on lung function, and being able to be repeated. This article aims to investigate the effect of cryoablation on the invasion and metastasis of transplanted tumors in Lewis lung cancer mice and establish a controlled experiment. The experimental group was 15 C57BL mice undergoing a single-cycle freezing-rewarming ablation operation. When the ice ball covered the edge of the tumor, the mice were re-warmed to 0??C and 40??C. The control group was the same 15 Only C57BL mice without any intervention. On the 14th day after cryoablation, immunohistochemical methods were used to measure the amount of Twist, E-cadherin, and VEGF-A in tumor tissues. The study results showed that the body and tumor masses of the experimental group using cryoablation 14 days after surgery were 4%-10% lower than that of the control group. Immunohistochemical staining results showed that the protein expression of Twist and VEGF-A in the experimental group was 2% lower than that of the control group, and the protein expression of E-cadherin was 6% higher than that of the control group. The average tumor suppression rate in the experimental group is 16.45%. In addition, the re-warming at 0??C after cryoablation has a better inhibitory effect on tumor invasiveness and metastasis than that at 40??C. The mechanism is related to the inhibition of epithelialmesenchymal transformation and tumor angiogenesis. Therefore, cryoablation has a specific inhibitory effect on the invasion and metastasis of transplanted tumors in Lewis lung cancer mice.

Platinum-based chemotherapy is the standard first-line treatment for advanced esophageal squamous cell carcinoma (ESCC). In this phase 3 study (ClinicalTrial.gov: NCT03829969), 514 patients with treatment-naïve advanced ESCC were randomized (1:1) to receive toripalimab or placebo in combination with paclitaxel plus cisplatin (TP) every 3 weeks for up to 6 cycles, followed by toripalimab or placebo maintenance. At the prespecified final analysis of progression-free survival (PFS), a significant improvement in PFS is observed for the toripalimab arm over the placebo arm (hazard ratio [HR] = 0.58; 95% CI, 0.46-0.74; p < 0.0001). The prespecified interim analysis of overall survival (OS) also reveals a significant OS improvement for patients treated with toripalimab plus TP over placebo plus TP (HR = 0.58; 95% CI, 0.43-0.78; p = 0.0004). The incidences of grade ≥3 treatment-emergent adverse events are similar between the two arms. Toripalimab plus TP significantly improves PFS and OS in patients with treatment-naïve, advanced ESCC, with a manageable safety profile.

目的 探讨单孔胸腔镜左肺上叶尖后段切除术的流程与安全性.方法 回顾分析2020年1月至2021年6月就诊于西南医科大学附属医院胸外科且行单孔胸腔镜左肺上叶尖后段切除术的患者资料,共23例,其中男8例,女15例,中位年龄53岁(34～67岁),所有患者均经左侧腋中线第5肋间切口,由叶间裂入路完成解剖性左肺上叶尖后段切除术.结果 叶间裂发育全13例,发育不全10例,均在单孔胸腔镜下完成手术,无中转多孔或开胸病例,中位手术时间100 min(85～120 min),中位术中出血量30mL(10～50mL),中位所需直线切割闭合器订舱5个(5～6个),中位术后带管时间3d(2～5d),中位术后住院时间3d(2～7d),中位淋巴结切除5枚(3～6枚),术后并发症2例,无相关死亡病例.结论 无论叶间裂发育全或不全,单孔胸腔镜下左肺上叶尖后段切除均是安全可行的,具有临床推广应用价值.

Purpose:Accurate clinical staging is crucial to managing esophageal cancer. [68Ga]Ga-DOTA-FAPI-04 exhibits good diagnostic performance in various tumors, showing a promising alternative to [18F]FDG. Here, we investigated the diagnostic performance of [68Ga]Ga-DOTA-FAPI-04 PET/CT and [18F]FDG PET/CT in the diagnosis of primary and metastatic lesions of esophageal cancer.Methods:Patients with esophageal cancer who underwent concurrent [68Ga]Ga-DOTA-FAPI-04 and [18F]FDG PET/CT between January 2020 and June 2021 were retrospectively analyzed. [68Ga]Ga-DOTA-FAPI-04 and [18F]FDG PET/CT uptakes were compared by using the paired samples t test. The McNemar test was used to compare the diagnostic performance between the two techniques.Results:Thirty-five patients (ranging from 44-83 years old with a median age of 63.5 years) were evaluated in our study. In treatment-naive patients (n=25), [68Ga]Ga-DOTA-FAPI-04 PET could detect all esophageal cancers, whereas 1 patient with superficial esophageal cancer was negative in FDG but positive in [68Ga]Ga-DOTA-FAPI-04 (T1). [68Ga]Ga-DOTA-FAPI-04 uptake was higher than [18F]FDG in primary lesions (13.8 ± 6.9 vs 10.9 ± 6.8, respectively, P=0.004), involved lymph nodes (9.3 ± 5.2 vs 6.4 ± 5.9, respectively, P=0.002), and bone and visceral metastases (10.4 ± 6.0 vs 6.1 ± 7.5, respectively, P=0.001). In addition, [68Ga]Ga-DOTA-FAPI-04 PET/CT has a higher detection sensitivity than [18F]FDG PET/CT for primary tumors [100% (25/25) vs. 96.0% (24/25), respectively], lymph nodes [95.0% (57/60) vs 75.0% (45/60), P<0.001], and bone and visceral metastases [100% (25/25) vs 72% (18/25), respectively; P= 0.008].Conclusion:[68Ga]Ga-DOTA-FAPI-04 PET/CT has higher tracer uptake value and is superior to [18F]FDG PET/CT in detecting primary and metastatic lesions in patients with esophageal cancer.

全球范围内肺癌仍然是所有癌症中发病率及死亡率最高的肿瘤,在中国,肺癌也是发病率最高的恶性肿瘤.其中又以非小细胞肺癌(NSCLC)最为多见,约占其总数的85％.以手术为主的综合治疗是肺癌主要的治疗方法,在非小细胞肺癌手术中胸腔镜技术逐渐成为首选的治疗手段.从开放到微创,从多孔到单孔,楔形切除、肺段切除、肺叶切除、全肺叶切除和袖式切除术等的运用越来越多,快速恢复(ERAS)理念一直都是外科手术致力于改善患者预后的不懈追求.更加直接的手术视野、更符合手术器械的应用、术后疼痛感的降低、美容效果好等一系列优点让单孔胸腔镜技术由此脱颖而出.虽然在非小细胞肺癌中单孔胸腔镜的应用前景十分广阔,但仍处于初步的探索阶段,存在如操作角度有限、器械间的相互干扰等一系列问题.本文就单孔胸腔镜在非小细胞肺癌手术中的应用进展与思考做一述评.

目的 探讨单孔胸腔镜在右上肺段切除术中的临床应用.方法 回顾性分析2021年1月至6月于西南医科大学附属医院胸外科行单孔胸腔镜右上肺段切除术的16例病人的临床资料,其中男7例、女9例,中位年龄52.5(36～68)岁.所有病人均行腋后线第5肋间切口.结果 所有病人均顺利完成手术,无中转为多孔或开胸手术者.中位手术时间145(80～205)min,中位术中出血量50(20～150)mL,中位术后胸管留置时间3(3～12)d,中位术后住院时间4(4～8)d,术后病理均诊断为腺癌.术后并发症1例,全组无围术期死亡.结论 单孔胸腔镜行右上肺段切除是安全可行的.

Purpose To observe the clinical application value of 68 Ga-FAPI-04 PET/CT in the preoperative detection of lymph node metastasis and staging of esophageal cancer. Methods A prospective analysis of 29 surgical patients was performed. 68 Ga-FAPI-04 PET/CT was performed within 1 week before the operation. All patients received enhanced CT during the same period. None of these patients had received preoperative treatment before the operation. The value of 68 Ga-FAPI-04 PET/CT and enhanced CT in the diagnosis of lymph node metastasis and preoperative staging of esophageal cancer was compared according to postoperative pathology. Results Both 68 Ga-FAPI-04 PET/CT and CT detected the primary tumor (29/29 cases). 637 lymph nodes were surgically removed, of which 37 lymph nodes were metastasized. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of PET/CT for lymph node metastasis detection were 71.1%, 99.4%, 97.8%, 90.0%, and 98.2%; The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CT for lymph node metastasis detection were 36.8%, 98.9%, 95.3%, 70.0%, and 96.1%, respectively. Conclusion 68 Ga-FAPI-04 PET/CT is better than enhanced CT in diagnosing lymph node metastasis and determining lymph node staging in esophageal cancer.

目的 探讨多学科诊疗(M D T)模式在食管异物患者中的应用效果.方法 选取2018年1月至2020年7月西南医科大学附属医院收治的121例食管异物患者为研究对象,根据诊疗模式分为试验组(n=62)和对照组(n=59).试验组采用MDT模式,对照组采用传统诊疗模式,对两组患者治疗等待时间、治疗后并发症发生率、平均住院日、平均治疗费用及病死率进行比较.结果 试验组治疗等待时间、平均住院日和平均治疗费用均优于对照组,两组比较差异有统计学意义(P<0.05).治疗后,试验组并发症发生率及病死率均更低,但与对照组比较,差异无统计学意义(P>0.05).结论 与传统诊疗模式相比,MDT模式能为食管异物患者提供最佳治疗方案,能更早取出异物,缩短住院时间,减少住院费用.

目的 探讨改良福勒(Fowler)体位在单孔胸腔镜胸交感神经链切断术中应用的可行性和安全性.方法 回顾性分析我院2018年1月～2020年10月82例手汗症的临床资料,改良福勒体位40例,传统侧卧位42例.改良福勒体位为在标准福勒体位基础上,双臂外展至90°～120°暴露双侧腋窝,先行右侧手术,再行左侧手术;传统侧卧位先左侧卧位行右侧手术,再改为右侧卧位行左侧手术.比较2组手术时间、麻醉时间、单侧手术双肺停止通气时间、术后疼痛评分、术后住院时间以及术后代偿性多汗等并发症.结果 2组手术均在单孔胸腔镜下顺利完成.与传统侧卧位组比较,改良福勒体位组手术时间短[(19.3±2.1)minvs.(33.6±2.6)min,t=-27.266,P=0.000],麻醉时间短[(30.1±2.2)minvs.(43.7±3.3)min,t=-22.258,P=0.000].2组单侧手术双肺停止通气时间、术后疼痛评分、术后住院时间、术后代偿性多汗等并发症差异均无统计学意义(P>0.05).结论 与传统侧卧位相比,改良福勒体位行胸交感神经链切断术能够避免中转体位,且疗效相当,是安全可行的.

Jianxing He, Hengrui Liang, Wei Wang, Andrey Akopov, Alberto Aiolfi, Keng-Leong Ang, Luca Bertolaccini, Kaican Cai, Qingdong Cao, Baojun Chen, Chang Chen, Chun Chen, Donglai Chen, Fengxia Chen, Jun Chen, Lei Chen, Mingwu Chen, Yongbing Chen, Zhuxing Chen, Chao Cheng, Dong Cui, Fei Cui, Tianyang Dai, Qinglong Dong, Paolo A. Ferrari, Raja M. Flores, Junke Fu, Soichiro Funaki, Marios E. Froudarakis, Xiangfeng Gan, Mingfei Geng, Jialong Guo, Qiang Guo, Yongtao Han, Jintao He, Kaiming He, Kyoji Hirai, Jian Hu, Shuqiao Hu, Jian Huang, Jun Huang, Wenfa Jiang, Kyung Soo Kim, Gabor Kiss, Fanyi Kong, Lan Lan, Xuefeng Leng, Bin Li, Gaofeng Li, Hecheng Li, Hefei Li, Heng Li, Jiwei Li, Xiaoqiang Li, Shuben Li, Yinfen Li, Zhuoyi Li, Yi Liang, Lixia Liang, Wenhua Liang, Yongde Liao, Wanli Lin, Xu Lin, Hongxu Liu, Hui Liu, Jixian Liu, Jun Liu, Xiang Liu, Zihao Liu, Xingzhao Lu, Qingquan Luo, Naiquan Mao, Qi Pan, Dazhi Pang, Jun Peng, Jun Peng, Eugenio Pompeo, Rulin Qian, Kun Qiao, Bassam Redwan, Zi Sang, Wenlong Shao, Jianfei Shen, Weiyu Shen, Sook-Whan Sung, Wenfang Tang, Tianhu Wang, Guangsuo Wang, Haitao Wang, Huien Wang, Jiyong Wang, Wen Wang, Yongyong Wang, Zhenyuan Wang, Li Wei, Wei Wei, Hao Wu, Jie Wu, Zhaohua Xia, Chenyang Xu, Enwu Xu, Hai Xu, Ning Xu, Quan Xu, Rongyu Xu, Shun Xu, Chaokun Yang, Hanyu Yang, Shengli Yang, Jun Yi, Guangjian Zhang, Hao Zhang, Jia Zhang, Man Zhang, Xiao Zhang, Yajie Zhang, Zhe Zhang, Zhifeng Zhang, Honglin Zhao, Jian Zhao, Xiaodong Zhao, Jianping Zhou, Yanran Zhou, Chengchu Zhu, Shaojin Zhu, Xinhai Zhu, Jian Cui, Yubo Yan, Ke-Neng Chen

68Ga-FAPI PET/CT is a useful method for tumor patients due to its low physiological uptake. Thymic squamous cell carcinoma is a rare mediastinal malignancy, which should be differentiated from other mediastinal tumors. Herein, we report the 68Ga-FAPI PET/CT findings in a 33-year-old man with thymic squamous cell carcinoma.

BACKGROUND:Immune-related genes (IRGs) are highly relevant to the progression and prognosis of esophageal squamous cell carcinoma (ESCC). A prognostic signature could be reliable in stratifying ESCC patients according to the risk score, which may help manage systematic treatments. In this study, a systematic and reliable immune signature was developed to estimate the prognostic stratification in ESCC. METHODS:Ribonucleic acid (RNA) expression data of 79 ESCC samples from the Cancer Genome Atlas (TCGA) database and 269 normal esophageal mucosal samples from the Genotype-Tissue Expression (GTEx) project database were downloaded from the University of California, Santa Cruz (UCSC) website to form a TCGA-GTEx dataset. First, we screened differentially expressed genes (DEGs) and then filtered IRGs based on the Immunology Database and Analysis Portal (ImmPort) database to obtain immune-related DEGs (IRDEGs). Next, a novel prognostic signature based on IRDEGs was developed using multivariable Cox analysis. Immune infiltration status was evaluated via single-sample gene set enrichment analysis (ssGSEA). ESCC tissues were grouped into three clusters in terms of immune infiltration (Immunity-L, Immunity-M, and Immunity-H) by applying an unsupervised hierarchical clustering algorithm. Finally, the samples were divided into high- and low-risk groups using the median of the risk score scores for GSEA pathway enrichment analysis in the three clusters. RESULTS:The prognostic signature based on IRDEGs (FCER1G, ISG20, and EGFR) performed moderately in prognostic predictions, with a concordance index (C-index) value of 0.73 [95% (confidence interval) CI: 0.63-0.84, P=2.02E-05] and an area under the curve (AUC) value of 0.817. The xenobiotic metabolism pathway was significantly enriched and up-regulated both in the high-risk group of the immunity-M and immunity-H clusters. CONCLUSIONS:The novel immune-related prognostic signature we constructed has a good prognostic, predictive ability and can be used as an independent prognostic indicator. Our study provides clinicians with a quantitative tool to predict the probability of individual survival time and helps clinicians select targets for immunotherapies and individualized treatment strategies for ESCC patients.

目的 探讨人工智能(AI)影像系统在肺部结节诊断中的真实世界数据.方法 收集我院2019年2月至2020年1月单治疗组患有肺部结节并行手术治疗的患者222例.运用基于自适应3D-CNN技术的AI影像系统分析其肺部结节影像,得出关于肺结节大小、密度、位置、良恶性的信息.查询患者术后病理诊断结果,比较AI影像系统分析结果与术后病理诊断结果符合情况,探究AI影像系统在真实世界肺结节诊断能力.结果 222例肺部结节患者AI影像系统分析结果灵敏度、特异度、总符合率、漏诊率分别为67.0％、34.5％、58.6％和33.0％(Kappa=0.0143,P>0.05).结论 AI影像系统在肺部结节诊断中可信度仍较低.