Colorectal cancer is the second and third most prevalent gastrointestinal tract malignancy among women and men. Over the past few decades, the incidence and mortality of colorectal cancer has gradually increased in China. Many studies have indicated that the robotic surgery system addresses several limitations of laparoscopic surgery and is a safe and feasible surgical approach. However, preservation of the left colic artery (LCA) during robotic total mesorectal excision (R-TME), along with short-term surgical outcomes and complications, has always been the focus of surgeons. Therefore, the present study aimed to analyze the short-term surgical effects of LCA preservation and postoperative complications within 30 days in patients with and without LCA preservation during R-TME. In this retrospective cohort study, we collected and analyzed the clinical data of R-TME performed at the anorectal Department of Gansu Provincial Hospital between January 2018 and January 2023. (In our center, the robotic Da Vinci Xi surgical system is utilized for surgical procedures.) The patients were divided into 2 groups according to whether the LCA was preserved during total mesorectal excision. A total of 150 patients were included in this study; 69 patients underwent LCA preservation, and 81 underwent LCA non-preservation surgeries. In the LCA preservation group, the first postoperative ventilation time (3.2 ± 1.3 days vs 4.2 ± 1.8 days, P = .000) and the time of the first postoperative fluid diet (4.9 ± 1.1 days vs 5.1 ± 1.6 days, P = .001) were significantly improved, and the incidence of protective ileostomy (4.3% vs 14.8%, P = .033) was significantly reduced compared with that in the LCA non-preservation group (P < .05). The overall complication rates within 30 days in the 2 groups were not significantly different. However, the incidence of anastomotic leakage in the LCA preservation group was significantly lower than that in the LCA non-preservation group (0.0% vs 7.4%, P = .021). R-TME is safe and feasible for the preservation of the LCA, and LCA preservation can promote gastrointestinal function recovery. In addition, LCA preservation ensures the extent of No. 253 lymph node dissection, significantly reduces the incidence of anastomotic leakage and ileal protective fistula and improves the patients' quality of life.

This study aims to comprehensively assess the effects of imatinib, nilotinib, and flumatinib in treating chronic myeloid leukaemia and to explore the main factors affecting its efficacy. Ninety-nine chronic myeloid leukaemia patients initially diagnosed and treated with one of these 3 tyrosine kinase inhibitors at a tertiary hospital in Shanxi Province between June 2018 and June 2023 were selected and divided into an imatinib group (n = 32), nilotinib group (n = 30), and flumatinib group (n = 37). Hematological response rates, cytogentic response rates, molecular response rates, and adverse reactions were compared among the 3 groups to statistically analyze efficacy and safety. Univariate analysis and logistic regression were used to explore the related factors influencing the curative effect. A nomogram prediction model of influencing factors of efficacy was constructed in R software and validated according to receiver operating characteristic and calibration curves, with a clinical decision curve and clinical impact curve further drawn to confirm its clinical practicability. The complete cytogenetic response at 3 months differed significantly, with rates of 53.13%, 76.67%, and 78.38% for the imatinib, nilotinib, and flumatinib groups, respectively (P < .05). Major molecular response (MMR) rates at 3 months were 25.00%, 53.33%, and 51.35%, reaching 78.13%, 90.00%, and 83.78% at 12 months, respectively. Deep molecular response (DMR) rates at 12 months were 50.00%, 76.67%, and 75.68% in each respective group (P < .05). Multivariate logistic regression indicated early molecular response, white blood cell count, red cell distribution width and platelet count as independent influencing factors of MMR. Age, drug type, early early molecular response, and red cell distribution width were identified as independent influencing factors of DMR (P < .05). The areas under the receiver operating characteristic curves for MMR and DMR nomogram models were 0.912(95% confidence interval: 0.833, 0.990)and 0.874 (95% confidence interval: 0.801, 0.946), respectively, indicating satisfactory model calibration. Nilotinib and flumatinib demonstrate superior efficacy over imatinib, with effectiveness influenced by various factors including sociodemographic characteristics, clinical heterogeneity, and drug side effects. The proposed clinical prediction model may provide valuable insights for decision-making and demonstrates generalizability and practical application value.

The association between systemic immune inflammatory index (SII) values and prostate cancer remain poorly understood. This study aimed to estimate the association between SII values and the risk of prostate cancer by analyzing the statistics on 10,485 participants in the National Health and Nutrition Examination Survey from 2011 to 2018. The quartile (Q) method was used to divide the participants into 4 groups on the basis of their SII values, from group Q1 (lowest SII values) to group Q4 (highest SII values). The association between the participants' SII values and the risk of prostate cancer was analyzed using weighted logistic regression models and a restricted cubic spline, and further subgroup analysis was conducted by age, body mass index; ethnicity; education level; and smoking, alcohol-drinking, hypertension, hyperlipidemia, and diabetes status. Higher SII values were found to be associated with a higher risk of prostate cancer. In comparison with Q1, the odds ratio of Q4 was 2.26 (95% confidence interval: 1.44-3.55). Subgroup analysis revealed that this positive association was more significant among non-Hispanic black participants than among other participants. In addition, the results of a sensitivity analysis demonstrated that the association between the risk of prostate cancer and the SII values was relatively stable. The SII values were found to be positively associated with the risk of prostate cancer and varied with ethnicity. Nevertheless, further prospective studies are required to confirm these findings.

Colorectal cancer (CRC) screening uptake in the Veterans Health Administration (VA) has been reported to be higher than the US general population, but CRC remains a prevalent cancer within the VA system. To examine CRC predictors and the extent to which the conventional definition of up-to-date screening applies to the population, we conducted a case-control study using VA data from 2012 to 2018. We classified patients into 5 categories: up-to-date or not up-to-date average-risk patients aged 50 to 75 (Categories 1 and 2), up-to-date or not up-to-date average-risk patients aged <50 or >75 (Categories 3 and 4), and high-risk patients (Category 5). Each CRC case was matched by age, sex, and facility with 4 controls. We performed multivariable conditional logistic regression, adjusting for race and ethnicity, diabetes, obesity, and alcohol use. Among 3714 CRC cases identified, Category 4 (odds ratio [OR] 1.40, 95% CI 1.11-1.78) and Category 5 (OR 6.23, 95% CI 5.06-7.66) patients had a higher risk of CRC compared to Category 1 patients. Compared with White patients, Black patients had a higher risk (OR 1.54, 95% CI 1.37-1.73). Diabetes (OR 1.65, 95% CI 1.51-1.81) and alcohol use disorder (OR 1.53, 95% CI 1.35-1.73) were also associated with CRC. Most CRC cases occurred in individuals aged 50 to 75, but 12.5% occurred in persons who were outside of this age range or had high-risk personal or family history. The conventional measure of CRC screening, focused on average-risk individuals aged 50 to 75, does not reflect screening status in an important minority of CRC patients.

The objective of this study is to investigate the genetic susceptibility and risk factors of EGF gene rs1897990 and rs1524106 in lung adenocarcinoma young patients aged ≤ 45 years.

A case-control study was conducted. DNA was extracted and identified from 88 samples from case and control groups by single-nucleotide polymorphism assay. PCR amplification was performed by TaqMan probe method, and the factors of smoking, drinking, sex, and age were also included. To investigate the clinical factors and genotyping differences between case and control groups.

Smoking was an influential factor in young lung adenocarcinoma patients. The mutation frequency of EGF gene rs1897990 CT heterozygous mutant was different between the two groups (p = 0.021). The T alleles of EGF rs1897990 and rs1524106 were significantly different between the two groups (p = 0.034 and p = 0.023).

The young lung adenocarcinoma population (≤ 45 years old) is susceptible to EGF rs1897990 and rs1524106 variants, with smoking being another risk factor. Additionally, smoking may enhance the risk of EGF rs1897990 and rs1524106 variants threatening the development of lung adenocarcinoma.

As a newer surgical technique, robotic-assisted minimally invasive esophagectomy (RAMIE) offers an alternative to conventional minimally invasive esophagectomy (cMIE) in the treatment of esophageal cancer. The objective of this study was to evaluate and compare postoperative outcomes of RAMIE versus cMIE in patients undergoing Ivor-Lewis esophagectomy at a high-volume institution. The medical records from patients who underwent minimally invasive Ivor-Lewis esophagectomy between 2015 and 2024 were retrospectively analyzed. Data on surgical and oncological outcomes, such as conversions to open surgery, lymph node yield, anastomotic leakage rates, postoperative complications, and mortality, were collected and evaluated. The analysis included a total of 250 patients: 170 underwent cMIE, and 80 underwent RAMIE. Patient baseline characteristics were comparable across both groups, except for differences in neoadjuvant therapy use. Importantly, no mortality was recorded within 30- or 90-day following RAMIE, and conversion rates were low in both cohorts. The rates of anastomotic leaks, major postoperative complications, and harvested lymph nodes were comparable across the two groups. Additionally, multivariable logistic regression analysis controlling for potential confounders confirmed that RAMIE and cMIE had similar leak rates. The current findings indicate that RAMIE represents a safe, feasible option comparable to cMIE, with potential ergonomic advantages and improved postoperative recovery. However, additional studies in larger groups will be necessary to validate these findings and determine long-term oncologic outcomes.

The emergency department (ED) is a common yet understudied route to cancer diagnosis. It has been reported that over 1 in 3 patients in Ontario, Canada, used the ED prior to cancer diagnosis.

To examine the association between ED use in the 90 days prior to cancer diagnosis and subsequent mortality.

This matched, retrospective, population-based cohort study used administrative health data from Ontario, Canada. Adults (aged ≥18 years) diagnosed with cancer between January 1, 2014, and December 31, 2021, were included. Patients were followed from index diagnosis until death, 7 years, or end of the study (March 31, 2024). To create the cohort, patients with and without ED use prior to diagnosis were matched 1:1 on sex and year of diagnosis, and then were propensity score matched.

Any ED visit in the 90 days prior to diagnosis.

The primary outcome was all-cause mortality after cancer diagnosis. A Cox proportional hazards regression model was used to estimate mortality risk. Interaction with time using restricted cubic splines was included to model the time-varying relationship between ED use and mortality. Results were stratified by hospitalization on the ED visit vs discharge from the ED.

A total of 205 060 (89.3%) patients with ED use prior to cancer diagnosis were matched to patients without ED use prior to diagnosis. Of the 410 120 total patients included, the mean (SD) age was 67.4 (15.0) years, and 106 681 (52.0%) per group were male. Overall mortality was 49.7%: 61.7% in patients with an ED visit vs 37.8% in patients without an ED visit. Patients with ED use prior to diagnosis had statistically significantly higher risk of mortality compared with those without ED use, which decreased with time but persisted through the 7-year follow-up (hazard ratio [HR] at 30 days: 4.49 [95% CI, 4.40-4.58]; HR at 1 year: 1.85 [95% CI, 1.82-1.88]; HR at 3 years: 1.48 [95% CI, 1.46-1.50]; HR at 7 years: 1.05 [95% CI, 1.01-1.09]). In stratified analysis, the increased hazard of death among patients with ED use was even higher among those admitted to the hospital vs the overall model, which persisted over the follow-up time (HR at 30 days: 5.83 [95% CI, 5.69-5.99]; HR at 1 year: 2.23 [95% CI, 2.19-2.27]; HR at 3 years: 1.74 [95% CI, 1.70-1.77]; HR at 7 years: 1.30 [95% CI, 1.23-1.37]). Patients discharged from the ED also had a greater hazard of mortality vs those without ED use, which persisted to 3 years of follow-up (HR at 30 days: 2.68 [95% CI, 2.59-2.77]; HR at 1 year: 1.81 [95% CI, 1.76-1.86]; HR at 3 years: 1.38 [95% CI, 1.34-1.41]; HR at 7 years: 1.03 [95% CI, 0.98-1.10]).

In this cohort study of patients diagnosed with cancer, those with ED use prior to cancer diagnosis had a higher hazard of mortality. This finding highlights the need for (1) established systems of care to ensure timely cancer workup for patients in the ED with suspected cancer and (2) health care system improvements to enhance early cancer detection and management to reduce reliance on emergency care for initial cancer presentations.

China-Net Childhood Lymphoma (CNCL) group B-NHL-2017 study is a prospective multi-center study in China, with the purpose of standardizing the diagnosis and treatment of childhood lymphoma, and improving the prognosis.

From May 2017 to June 2023, 20 centers participated in the diffuse large B-cell lymphoma (DLBCL) study. The clinical data were analyzed to summarize the clinical characteristics, treatment response and outcome. The primary endpoint was 5-year event-free survival (EFS). The trial is registered with the Chinese Clinical Trial Registry (ChiCTR1800020067).

A total of 138 children and adolescents were enrolled, including 101 males and 37 females. The median age of disease diagnosis was 9.0 years (range: 2.3-15.5 years). The range of follow-up time was 17 d-6.0 years. A total of 12 events occurred in this study, including 7 deaths. of which 4 patients died of disease and chemotherapy comorbidities (severe infection, septic shock, etc.), 1 died of disease progression (enlargement of the primary tumor and tumor metastasis), 1 died of recurrence, and 1 died of severe pneumonia in the third year after completing all chemotherapy courses. Recurrence occurred in 6 (4.3%) patients at 14.9 months (range: 4.4-32.6 months) after initial treatment. The 5-year overall survival (OS) was 90.7 ± 5.0% and the 5-year EFS was 85.5 ± 5.4%. Based on Cox regression analysis, no Rituximab during treatment is an independent risk factor for mortality in patients with DLBCL.

The efficacy of CNCL-B-NHL-2017 protocol in the treatment of DLBCL in children and adolescents is close to results of international studies.

Objective: To explore the effects and prognosis of heavy ion therapy for thoracic and abdominal malignant tumors under different frequency settings of high-frequency oscillatory breathing control. Methods: A prospective randomized controlled trial was conducted on 45 patients with thoracic and abdominal malignant tumors who received heavy ion therapy under high-frequency oscillatory ventilation (HFOV) control at Gansu Wuwei Tumour Hospital from January 2023 to December 2024. The patients were randomly divided into three groups by block randomization, with 15 patients in each group, and they received different HFOV frequency settings (6 Hz, 7 Hz and 8 Hz, i.e., 360 breaths/min, 420 breaths/min and 480 breaths/min), while other parameters were kept constant (oxygen concentration: 40%, mean airway pressure: 10 cmH₂O, amplitude: 6cm). The arterial blood gas, transcutaneous carbon dioxide partial pressure/transcutaneous oxygen partial pressure (TcPCO₂/TcPO₂), duration of HFOV ventilation, duration of invasive mechanical ventilation, length of hospital stay and complications of the patients under different frequency settings were analyzed. Results: Before and after treatment, there was no statistically significant difference in arterial blood gas parameters (PaCO₂, PaO₂), oxygenation index, blood lactate, bicarbonate ion) among the 6 Hz,7 Hz and 8 Hz HFOV frequency groups (all P＞0.05). At 30 minutes, 60 minutes, 120 minutes of treatment and at extubation, there was no statistically significant difference in TcPCO₂, TcPO₂, SpO₂ and heart rate among the 6 Hz, 7 Hz and 8 Hz HFOV frequency groups (all P＞0.05). The HFOV duration of the 6 Hz, 7 Hz and 8 Hz HFOV frequency groups was (131.7±8.4) minutes, (125.3±6.9) minutes and (115.7±10.5) minutes, respectively; the duration of invasive mechanical ventilation was (212.3±21.2) minutes, (190.7±14.8) minutes and (199.3±18.4) minutes, respectively; the tumor shrinkage rate was (53.1±6.1)%, (64.7±5.1)% and (63.0±6.2)%, respectively; and the hospital stay was (22.7±2.9) days, (22.3±3.1) days and (20.8±3.3) days, respectively. There was no statistically significant difference among the groups (all P＞0.05). Only one patient developed reversible hypercapnia, which returned to the normal range within 30 minutes after adjusting the invasive ventilator parameters. No treatment-related adverse events such as hypoxemia, radiation pneumonitis, or hemodynamic instability occurred in any of the subjects. Conclusions: HFOV management under heavy ion therapy for thoracoabdominal malignancies shows no significant changes in arterial blood gas analysis before and after treatment at different frequencies (6 Hz, 7 Hz, 8 Hz). Continuous monitoring of transcutaneous TcPCO₂/TcPO₂ is stable. The treatment process is safe, with few complications and good results.

Hepatocyte nuclear factor 4 alpha (HNF4α) contributes to tumorigenesis and cancer progression. This study evaluated the diagnostic potential of HNF4α for detecting endocervical glandular lesions (EGLs), including endocervical adenocarcinomas (ECAs), adenocarcinomas in situ (AIS), and lobular endocervical glandular hyperplasias (LEGH) using alcohol-fixed cytological smears.

HNF4α expression was immunocytochemically assessed in alcohol-fixed smears and paired formalin-fixed paraffin-embedded tissue specimens obtained from 14 patients with histologically confirmed EGLs: eight papillomavirus-associated (HPVA) ECAs, one non-NHPVA ECA, two HPVA AIS, and three patients with LEGHs. Three cases of squamous cell carcinomas (SCCs) and two cases of non-neoplastic lesions were also analyzed as non-EGL controls. HNF4α positivity was defined as nuclear staining in one or more cell(s)/slide, regardless of intensity.

Histologically confirmed EGL cases were cytologically diagnosed as four adenocarcinomas, eight atypical glandular cells, one misclassified atypical squamous cells of undetermined significance, and one misclassified SCC, with a sensitivity of 85.7% and specificity of 100%. Strong and diffuse nuclear HNF4α expression was observed in atypical glands in both smears and tissue specimens, whereas non-neoplastic glands and non-neoplastic/neoplastic squamous epithelium were HNF4α-negative. HNF4α expression showed 73.7% concordance between tissue and smear samples. Notably, HNF4α immunocytochemistry demonstrated 100% sensitivity and specificity for detecting EGLs, outperforming cytomorphological or immunohistochemical diagnosis (sensitivity, 71.4%; specificity, 100%).

HNF4α is a reliable diagnostic marker when using alcohol-fixed smears, showing enhanced accuracy for EGLs detection regardless of human papillomavirus status. Immunocytochemical analysis of HNF4α in cervical smears can be used for EGL detection and early diagnosis of cervical cancer.