Lung adenocarcinoma (LUAD) is the most common histological subtype of non-small cell lung cancer (NSCLC). Due to the lack of obvious symptoms and signs in the early stages, most patients are already in the middle or late stages at diagnosis. This makes treatment difficult and prognosis poor. Therefore, the identification of effective and specific biomarkers for lung cancer remains a focal area of research. So this study aimed to investigate the expression and clinical significance of S100 calcium-binding protein P (S100P) in LUAD.

Tissue samples of LUAD (n=50), adjacent normal lung tissue (n=50), and benign inflammatory lesions (n=50) were collected from The Affiliated Cancer Hospital, Guangzhou Medical University, used as the LUAD group, normal group and benign group. Immunohistochemistry (SP method) was employed to detect the expression of S100P, C-C chemokine ligand 4 (CCL4), and cluster of differentiation 8 (CD8) proteins. Correlation analyses were carried out.

Database analysis (UALCAN, GEPIA2) identified S100P as an mRNA with high expression in LUAD. Immunohistochemistry demonstrated that the protein levels of S100P and CCL4 were significantly higher in lung tissues of the LUAD group compared to those in the normal group and benign group (all P<0.05). The area under the curve (AUC) of S100P for differentiating LUAD was 0.943. The expression of S100P showed no significant correlation with age, sex, tumor size, or degree of differentiation (all P>0.05). Correlation analysis revealed that S100P expression was moderately positively correlated with CCL4 (r=0.611, P<0.001), and positively correlated with CD8+ lymphocyte infiltration (r=0.461, P<0.001). CCL4 expression was also positively correlated with CD8+ infiltration (r=0.400, P<0.001).

Database analysis indicates that S100P is highly expressed in LUAD and associated with a poor prognosis, making it a potential biomarker for the prognosis of LUAD. Clinical tissue analysis further shows that S100P expression is correlated with CD8+ lymphocyte infiltration in LUAD, suggesting that S100P can serve as a biomarker of lymphocyte infiltration and a potential predictor of the response to immune checkpoint inhibitors.

The mesenchymal-epithelial transition factor (MET) gene, located on human chromosome 7, exerts critical regulatory roles in cellular processes including proliferation, migration, invasion, and angiogenesis. As a key driver gene in non-small cell lung cancer (NSCLC), MET abnormalities encompass MET exon 14 (METex14) skipping mutations, gene amplification, protein overexpression, gene fusions, and activating mutations. This consensus, developed by the Lung Cancer Specialty Committee of the Chinese Elderly Health Care Association, updates the 2025 version with several key modifications: elevating the recommendation level for MET amplification and protein overexpression testing, advocating routine testing for all newly diagnosed NSCLC patients and those with acquired resistance to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs); standardizing targeted therapy approaches for MET amplification in driver gene-negative settings and following EGFR-TKIs resistance; and subdividing MET protein overexpression-related management into post-EGFR-TKIs resistance and driver gene-negative categories with corresponding treatment protocols, thereby offering more actionable guidance for precise clinical decision-making.
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With the wide application of low-dose spiral computed tomography and the advancement of imaging technology, the detection rate of pulmonary nodules has significantly increased. However, the traditional "one-size-fits-all" management strategy has been unable to meet the needs of precise diagnosis and treatment. This expert consensus was initiated by Professor Chunxia SU's team and Professor Chang CHEN's team from Shanghai Pulmonary Hospital and jointly formulated by experts from multiple disciplines including oncology, respiratory medicine, thoracic surgery, interventional medicine, radiology, and pathology. The aim is to provide scientific and practical decision-making references for clinical controversies that are less addressed or have differences in existing guidelines. The consensus uses the GRADE method for evidence assessment and forms 18 recommendations through two rounds of Delphi questionnaire surveys, focusing on differentiated screening for special populations, artificial intelligence assisted diagnosis, robot-assisted puncture, application of molecular markers, active monitoring of low-risk nodules, timing of invasive intervention, termination conditions of follow-up, management strategies for multiple nodules, and selection of individualized lymph node dissection range and surgical methods for early-stage lung cancer. This consensus would provides supplementary guidance for the entire process of precise management of pulmonary nodules from screening to treatment, with expectation of improving the long-term survival rate of lung cancer patients while minimizing unnecessary medical interventions and enhancing the quality of life of patients.
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A subset of uterine leiomyomas becomes clinically apparent during pregnancy/delivery and is typically excised during Cesarean section. Although benign, these leiomyomas excised during pregnancy and/or delivery (LEPs) can pose diagnostic challenges due to morphologic changes that mimic malignant mesenchymal neoplasms, such as leiomyosarcoma. This study analyzed 97 LEPs to characterize their histopathologic and immunohistochemical features. Histologic examination revealed predominantly low mitotic activity (mean: 0.5 mitoses/10 HPFs) and mild (87.6% of tumors) to at most focal moderate (9.3% of tumors) nuclear atypia. Ischemic necrosis occurred in 57.7% of tumors. Features attributed to coagulative necrosis were common, including sharp viable-nonviable transition (22.7%), perivascular tumor preservation (9.3%), and ghost outlines of tumor cell nuclei (50.5%). Focal myxoid changes, affecting ≤30% of tumor volume, were seen in 42.3% of tumors. Rare, bizarre cells were identified in 48.5% of tumors. Immunohistochemistry demonstrated the absence of estrogen receptor staining in 65% of tumors, with focal staining in 35.2%, and progesterone receptor expression in 97.7%. Caldesmon (98.9%) and desmin (100%) were positive, with the majority diffuse. CD10 (100%) showed variable staining intensity. Wild-type p53 expression was seen in all tumors tested. Expression of ATRX, MTAP, RB1, and PTEN was predominantly retained with equivocal staining in 35.3% (ATRX) and 3.4% (RB1) of tumors. Although Cyclin D1 expression was common (97.4%), it was always focal, with no diffuse (≥70%) strong nuclear staining. FH loss occurred in 3.2% of tumors. All tumors were negative for MelanA, and 92.4% were negative for HMB45. Calretinin expression was observed in 39% of tumors, typically focal and strong, while only 1 tumor showed positive inhibin staining in <5% of cells. ALK expression was focally positive or equivocal in 9.6% of cases, but no gene rearrangements were identified by in situ hybridization. Follow-up data were available for 71 patients (mean: 56 mo), with no malignant transformation or recurrence. These findings confirm that LEPs exhibit distinct morphologic and immunophenotypic alterations, including features typically attributed to coagulative tumor cell necrosis. However, given benign clinical outcomes, low mitotic activity, and lack of significant atypia, such a finding does not warrant designation as leiomyosarcoma or smooth muscle tumor of uncertain malignant potential in the context of concurrent pregnancy.

To elucidate the clinicopathological characteristics of intraductal papillary neoplasm of the bile duct (IPNB) and evaluate the sensitivity of multi-modality imaging techniques. Specifically, this study aims to: (1) characterize the ultrasound (US) features of intraluminal masses and bile duct dilation patterns; (2) systematically analyze the differential diagnostic criteria between invasive and noninvasive IPNB subtypes.

A retrospective cohort study included 48 histopathologically confirmed IPNB patients. Demographic, clinical, and imaging data were retrospectively collected. US features of intraluminal masses and bile duct dilation were systematically described. Receiver operating characteristic (ROC) curve analysis was performed to identify optimal biomarkers for differentiating invasive versus noninvasive IPNB, with sensitivity, specificity, and accuracy calculated.

The sensitivity rate of IPNB using different imaging methods was as follows: CEUS 39.6%; CECT 32.5%; MRI 29.2%. Arterial enhancement of the intraluminal mass and bile duct dilation was the most important US features, which were detected in 40 (83.3%) and 47 patients (97.9%) respectively. Bile duct dilation can be further classified as cystic dilation/diffuse upstream bile duct dilation/slight peripheral bile duct dilation. Intraluminal mass can be polypoidal-like/plaque-like/invasive pattern. Bilirubin, CEA, and SCC levels differed significantly between invasive/noninvasive groups (all p < 0.05). Notably, when SCC < 0.55 μg/L and total bilirubin (TB) > 29.35 μmol/L were used as diagnostic markers, the diagnostic specificity increased to 100%, with a sensitivity of 54% and an accuracy of 87.5%, showing the best diagnostic performance.

This study systematically described intraluminal mass morphologies and bile duct dilation patterns in IPNB using CEUS. The combined biomarker criterion (SCC < 0.55 μg/L and TB > 29.35 μmol/L) demonstrated exceptional specificity (100%) and accuracy (87.5%) for differentiating invasive from noninvasive IPNB, providing a potential clinical tool to guide therapeutic strategies.

Background/Objectives: Insulin resistance is increasingly recognized as a cause of colorectal neoplasms, but its measurement requires fasting insulin, which is not routinely available in clinical settings. The triglyceride-glucose (TyG) index, derived from fasting triglyceride and glucose, has emerged as a simple surrogate of insulin resistance. We aimed to evaluate the association of the TyG index with colorectal adenoma, identify a clinically usable cut-off, and examine whether the association is preserved across major subgroups. Methods: We conducted a cross-sectional analysis of 7251 asymptomatic adults who underwent screening colonoscopy and same-day biochemistry at university hospital health care centers in Daejeon and Chungcheong province of South Korea between November 2019 and June 2022. The TyG index was calculated as ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Multivariable logistic regression was used to estimate odds ratios (ORs) for adenoma; discrimination was evaluated by area under the receiver-operating-characteristic curve (AUC), and the optimal cut-off was identified by Youden's J. Large adenoma (≥10 mm) was analyzed as a secondary outcome. Results: Among 7251 participants (mean age 54.1 ± 11.2 years; 59.7% male; mean BMI 24.7 ± 3.4 kg/m²), 2402 (33.1%) had at least one colorectal adenoma. Adenoma prevalence rose monotonically across TyG quartiles (Q) (Q1, 26.3%; Q2, 32.0%; Q3, 35.5%; Q4, 38.7%; p for trend <0.001). A 1-standard deviation (SD) increase in TyG index was associated with adenoma prevalence in the fully adjusted model (OR 1.13, 95% confidence interval (CI) 1.06-1.20), and the Q4-versus-Q1 OR was 1.29 (1.09-1.53). The optimal cut-off for adenoma was TyG index = 8.55 (AUC 0.564, sensitivity 59.1%, specificity 50.8%); the association was modestly stronger for large adenoma (AUC 0.585; adjusted OR per 1-SD 1.25, 1.09-1.43). Subgroup analyses showed consistent effects across sex, age, body mass index, hypertension, diabetes, and metabolic-syndrome strata (all p for interaction >0.17). Conclusions: In a large screening cohort, an elevated TyG index was associated with the presence of colorectal adenoma, with a graded dose-response relationship and a modestly more pronounced association for large adenoma. Although discrimination by TyG index alone is too modest to support its use as a stand-alone screening tool, the index may serve as a low-cost adjunct within a multifactorial risk-stratification framework.

Introduction: Breast cancer-related lymphedema (BCRL) is a disabling complication, and the effectiveness of exercise as treatment remains uncertain. Objective: We aimed to evaluate the effectiveness and safety of exercise in women with BCRL. Methods: A comprehensive search was conducted in MEDLINE, Embase, Cochrane Library, PEDro, and LILACS from database inception to March 2025, collating systematic reviews (SRs) of randomized controlled trials (RCTs) evaluating exercise, alone or combined with physiotherapy, in women with BCRL. Risk of bias was assessed using ROBIS and RoB 2, certainty of evidence (CoE) using GRADE, and overlap using GROOVE. Results: Of 2023 records, 9 SRs including 170 primary studies were included; after overlap management, eligible RCT data were synthesized by comparison and outcome. Supervised weightlifting probably reduced the risk of a ≥5% long-term increase in lymphedema volume (RR: 0.13; 95% CI: 0.07-0.25; moderate CoE), but evidence is very uncertain regarding ≥5% volume reduction (RR: 0.85; 95% CI: 0.44-1.66; very low CoE). Aquatic exercise may improve shoulder flexion (MD: 8.73 degrees; 95% CI: 3.55-13.91; low CoE) and shoulder abduction (MD: 6.87 degrees; 95% CI: 2.50-11.24; low CoE) compared with Pilates. No adverse events were reported, although they were not systematically defined or reported. Conclusions: Supervised weightlifting probably prevents increases in lymphedema volume, and aquatic exercise may improve shoulder mobility; however, the evidence remains uncertain, and the absence of adverse events does not confirm safety. Registration: PROSPERO (CRD42022334433).

Background: Adjuvant therapy decisions for T3N0 stage II colon cancer remain controversial. This study evaluates long-term outcomes, recurrence patterns, and conditional relapse-free survival (RFS) in pathologic T3N0 colon cancer. Methods: This retrospective study included 306 patients undergoing curative resection for T3N0 colonic adenocarcinoma (1995-2020). Early recurrence was defined as recurrence or death within 3 years after surgery. Survival was estimated via Kaplan-Meier. Cox regression, adjusted for treatment eras, evaluated survival factors. Inverse Probability of Treatment Weighting (IPTW) minimized selection bias. Conditional RFS utilized a 5-year landmark analysis. Results: Over a 133-month median follow-up, 72 patients (23.5%) recurred. Most recurrences (81.9%) occurred within 3 years; only 9.7% after 5 years. Five- and 10-year OS rates were 80.9% and 70.4%. Inadequate lymph node dissection (<12 nodes) was performed in 29.7% of the entire cohort and was found to be an independent adverse prognostic factor for OS. Adjuvant chemotherapy lacked overall OS benefit, though IPTW analysis suggested potential benefit in patients with inadequate dissection. Conditional RFS (5-10 years) for patients recurrence-free at 60 months was 95.0%. Exploratory analyses showed descriptive differences in post-relapse survival based on the clinical triggers prompting radiological evaluation (marker-triggered versus symptom-triggered presentations). Conclusions: T3N0 colon cancer recurrences occur predominantly within the first 3-5 years after surgery. Inadequate lymph node dissection is the primary adverse prognostic factor. Although a 5-year follow-up period appears adequate for most patients, individualized extended surveillance may be considered for selected high-risk patients. Adjuvant treatment and follow-up strategies should be tailored according to surgical quality and risk factors.

Background: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms, accounting for approximately 1-3% of all gastrointestinal tumors, with an annual incidence of 1-2 cases per 100,000 population worldwide. They arise from the interstitial cells of Cajal and are most commonly located in the stomach and small intestine. Methods: We report a case of a 39-year-old man admitted with a preliminary diagnosis of an appendiceal inflammatory mass with suspected abscess formation. Results: The patient presented with right iliac fossa pain, fever, signs of pronounced systemic intoxication and laboratory findings consistent with inflammatory syndrome. Abdominal computed tomography revealed a mass in the right iliac region with infiltration of the surrounding adipose tissue, suggestive of an appendiceal infiltrate. Emergency surgical exploration identified a tumor originating from the cecum. Radical resection of the ileocecal region with side-to-side ileo-ascending anastomosis was performed. Histopathological examination confirmed a spindle-cell variant of GIST. The postoperative course was uneventful. Conclusions: This case highlights the diagnostic challenges of atypically localized GISTs, which may clinically and radiologically mimic inflammatory conditions such as appendiceal infiltrate. Conventional imaging modalities may be insufficient for definitive differential diagnosis. Surgical resection remains the cornerstone of treatment, with histopathological and immunohistochemical evaluation establishing the final diagnosis. Early identification and complete tumor excision are essential for optimizing clinical outcomes and long-term prognosis. Adjuvant therapy with tyrosine kinase inhibitors should be considered based on individual recurrence risk.

Tumor microenvironment influences the process of tumorigenesis, with hypoxia being a characteristic of many solid tumors and an adverse prognostic factor. Carbonic anhydrases (CAs) are highly efficient zinc-containing enzymes that are overexpressed in many cancers, particularly under acidic and hypoxic conditions. CA IX expression promotes cancer cell proliferation, migration, and invasion. Vascular endothelial growth factor receptor-2 (VEGFR-2) is a tyrosine transmembrane (ΤΜ) protein regulating embryonic development, angiogenesis, tissue homeostasis and cancer. Blocking VEGFR-2 signaling is one of the most promising approaches to hindering angiogenesis and growth of cancer cells. The epidermal growth factor receptor (EGFR) is a member of the ERBB family of receptor tyrosine kinases and plays a key role in cancer progression. EGFR is uniquely found in some brain, lung and other cancers. Development of novel strategies to regulate these factors is important for the treatment of tumors. Multifunctional drugs that act on multiple pathways offer a promising approach, improving therapeutic effectiveness while reducing side effects. The present review focuses on novel compounds that inhibit CA IX and target VEGFR-2 or EGFR.