Primary parotid lymphoma can closely mimic epithelial salivary gland tumors, making preoperative diagnosis challenging. We report the case of a 21-year-old female patient who presented with a left parotid swelling. Imaging was suggestive of a parotid neoplasm, and ultrasound-guided fine needle aspiration cytology (FNAC) demonstrated atypia of undetermined significance (Milan category III). The patient underwent a left total conservative parotidectomy. Histopathological examination with immunohistochemistry (IHC) established the diagnosis of diffuse large B-cell lymphoma (DLBCL), non-germinal center subtype, with involvement of the medial resection margin. She subsequently underwent staging evaluation and received systemic chemotherapy, with a favorable clinical response, and is currently disease-free on follow-up. This case highlights the diagnostic challenges associated with primary parotid lymphoma and underscores the importance of continued reporting of such cases to support the development of improved preoperative diagnostic strategies and management protocols.

Cervical cancer remains a significant public health issue and is the second leading cause of cancer-related mortality among women globally. Its burden extends beyond individual health, affecting families, communities, and social systems. This study aimed to identify the factors influencing Pap smear testing among women of reproductive age in Owerri West, Imo State.

This study adopted a descriptive cross-sectional design using 399 respondents selected through a multistage sampling method. Data were collected using a structured questionnaire and analysed with the Statistical Package for the Social Sciences (SPSS), with results presented in frequencies and percentages.

Most respondents were married (51.6%), aged 20-29 years (42.9%), predominantly traders (34.6%) and civil servants (34.9%), of Igbo ethnicity (78.0%), and had tertiary education (48.4%). While 44.8% had heard of cervical cancer, they were not familiar with its details. About 59.0% had heard of Pap smear testing, with nearly half (49.3%) receiving the information from healthcare professionals. Despite a relatively high level of awareness, 61.8% had never undergone a Pap smear. Respondents identified several barriers to Pap smear testing, including the belief that the procedure is expensive or embarrassing. Some also associated undergoing the test before sexual activity with a loss of virginity, while others cited the distant location of screening centres as a significant challenge.

There is a critical need for increased medical education and public sensitization on cervical cancer and the importance of routine screening to improve uptake and early detection.

Concomitant medications may influence the tumor-immune microenvironment and potentially affect the efficacy of immune checkpoint inhibitors (ICIs), yet their impact in hepatobiliary malignancies remains poorly defined. We evaluated the associations of antibiotic (ATB) exposure and indication-specific corticosteroid (CS) use with clinical outcomes in hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA).

In this retrospective cohort of 759 ICI-treated patients (511 HCC, 248 CCA), patients were stratified into four groups: no exposure (None, n=251), ATB only (n=135), CS only (n=183), and combined exposure (Both, n=190). ATB exposure was defined as systemic use within ±30 days of ICI initiation, and CS exposure as ≥10 mg prednisone-equivalent daily for ≥3 consecutive days. Inverse probability of treatment weighting (IPTW) and multivariable Cox models were used to adjust for confounding. Additional baseline-only sensitivity analyses restricted exposure to the 30 days before ICI initiation to reduce potential time-related bias.

After IPTW adjustment, baseline covariates were well balanced across exposure groups. Combined ATB and CS exposure was associated with significantly worse overall survival (OS) (adjusted HR 3.09, 95% CI 2.31-4.13; p<0.001) and progression-free survival (PFS) compared with no exposure. Objective response rates were comparable across groups (p=0.20), suggesting a greater association with impaired response durability rather than initial tumor shrinkage. Among CS-treated patients, corticosteroid use for immune-related adverse event (irAE) management was associated with improved OS compared with non-irAE indications (p<0.01). Landmark and baseline-only sensitivity analyses demonstrated generally consistent findings.

Antibiotic exposure and corticosteroid use for non-irAE indications were associated with inferior survival outcomes in ICI-treated hepatobiliary malignancies. These findings suggest that concomitant medication exposure may influence the durability of immunotherapy responses in real-world clinical settings. In contrast, corticosteroid use for irAEs was not associated with compromised outcomes, supporting the importance of context-specific corticosteroid administration during immunotherapy. Clinically, these findings highlight the importance of judicious antibiotic use and careful consideration of corticosteroid indications during ICI treatment.

Microsatellite-stable colorectal cancer (MSS-CRC) is refractory to immune checkpoint inhibitors (ICIs), mainly because of low tumor immunogenicity, impaired antigen presentation, immune exclusion, and myeloid- or Treg-dominated immunosuppression. Traditional Chinese medicine (TCM), characterized by multi-component and multi-target regulation, may provide complementary approaches for modulating these resistance barriers. This review summarizes the rationale, evidence, and translational requirements for integrating TCM with ICI-based therapy in MSS-CRC.

To evaluate the potential of TCM to regulate immune-resistance mechanisms in MSS-CRC and to propose a barrier-oriented framework for rational TCM-ICI combination strategies.

A structured narrative review was conducted in PubMed, Web of Science, Embase, Scopus, CNKI, and Wanfang for studies published from January 2019 to March 2026. Searches covered MSS/pMMR CRC, immune checkpoint blockade, TCM interventions, tumor microenvironment, microbiota, immunometabolism, syndrome patterns, active constituents, and herbal quality control. Eligible studies addressed MSS/pMMR CRC immunotherapy, TCM or phytomedicine-based interventions, or immune-resistance mechanisms. Direct MSS/pMMR CRC studies involving ICI combinations were prioritized, while broader CRC, cross-cancer, pharmacological, and computational studies were used as supportive evidence.

Selected TCM interventions may improve ICI responsiveness in MSS-CRC when matched to specific resistance barriers. Representative interventions include Zhenqi Fuzheng Granules, Shenqi Yichang Formula, Gegen Qinlian Decoction, modified Shenling Baizhu San, Changweiqing, and electroacupuncture-related evidence. These interventions have been linked to immunometabolic remodeling, dendritic-cell mitophagy and antigen presentation, microbiota-driven TME remodeling, Tfh-B-cell interactions, and STING-dependent immune activation. However, direct formula-specific clinical evidence for ICI sensitization in molecularly defined MSS-CRC remains limited. Clinical-translational evidence includes an early phase II study of electroacupuncture combined with fruquintinib and sintilimab in refractory MSS-mCRC, whereas most herbal-formula evidence remains preclinical or indirect. We therefore propose matching TCM interventions and active ingredients to dominant immune-resistance phenotypes and integrating syndrome-informed host-state stratification. These hypotheses require validation using causal assays, organoid-immune co-culture, single-cell/spatial omics, pharmacological standardization, and biomarker-enriched clinical trials.

TCM may serve as a complementary, mechanism-informed candidate sensitization strategy for MSS-CRC immunotherapy, but it is not an established standard combination approach. Future translation requires formula-specific and component-level validation, reproducible immune and microbiota-metabolic biomarkers, TCM syndrome assessment, herbal quality control, safety monitoring, and clinically meaningful outcomes.

This study aimed to compare the efficacy of postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) and adjuvant lenvatinib plus tislelizumab (PA-LT) in patients with Barcelona Clinic Liver Cancer (BCLC) stage 0-B hepatocellular carcinoma (HCC) who were at high risk of recurrence following radical liver resection (LR).

This study retrospectively evaluated HCC patients who underwent LR at two clinical centers between January 1, 2019 and January 31, 2025. Recurrence-free survival (RFS) and overall survival (OS) were compared across three groups: LR alone, PA-TACE, and PA-LT. Propensity score matching (PSM) was conducted to reduce intergroup heterogeneity and to enhance the robustness of the results.

A total of 614 patients with HCC at high risk of recurrence after radical resection were included in this study. After PSM, 148, 223, and 75 patients were retained in the LR, PA-TACE, and PA-LT groups, respectively. Compared with the LR group, both the PA-TACE and PA-LT groups were associated with significant improvements in RFS and OS (all p < 0.001), and no severe adverse events were observed in either group. However, no significant differences in RFS or OS were observed between the PA-TACE and PA-LT groups (median RFS: 44.00 months (95% CI, 40.91-47.09) vs. 40.50 months (95% CI, 34.90-46.10), p = 0.086; median OS: 69.00 months (95% CI, 66.44-71.56) vs. 65.00 months (95% CI, 60.93-69.07), p = 0.572). Multivariable Cox regression analysis demonstrated that both PA-TACE and PA-LT were independently associated with improved RFS and OS.

Both PA-TACE and PA-LT were associated with improved RFS and OS in hepatocellular carcinoma patients at high risk of recurrence after radical resection, with acceptable safety profiles. However, no significant differences were observed between the two adjuvant treatment strategies.

Coagulation activation and tumor hemorrhage are common in colorectal cancer, but their combined immunological meaning remains incompletely defined. We developed a prespecified hemorrhage-coagulation immune phenotype (HCIP) integrating local hemorrhagic pathology and systemic coagulation activation, and evaluated its association with recurrence-free survival (RFS), CD163/HO-1-enriched immune remodeling, and incremental prognostic value.

This retrospective cohort study included patients who underwent radical resection for colorectal adenocarcinoma at The First People's Hospital of Jiashan County between January 2016 and December 2025. HCIP was defined from a local hemorrhagic axis, based on H&E-assessed intratumoral hemorrhage and hemosiderin/Prussian blue evidence, and a systemic coagulation axis, based on preoperative fibrinogen, D-dimer, and platelet count. The primary outcome was RFS. A balanced FFPE subset was used for exploratory immunohistochemical assessment of CD8, CD68, CD163, HO-1, fibrinogen/fibrin, and tissue factor. Cox models, prespecified sensitivity analyses, and validation-cohort prediction analyses with bootstrap uncertainty estimates were performed.

The final analytic cohort included 752 patients. HCIP-poor tumors were enriched for advanced AJCC stage, larger tumor size, ulceration, and necrosis. In the balanced FFPE subset, HCIP-poor tumors showed lower CD8+ stromal T-cell density, higher CD163+ macrophage density, stronger HO-1, fibrinogen/fibrin, and tissue factor staining, a lower CD8/CD163 ratio, and a higher macrophage-heme-coagulation score. In multivariable Cox analysis, HCIP-poor status was associated with worse RFS (adjusted HR 1.91, 95% CI 1.33-2.73). The association remained directionally consistent in stage II/III-only, T/N-stage-adjusted, MSI/MMR-stratified, IPTW, and recurrence-only sensitivity analyses. Among individual hemorrhage/coagulation components, fibrinogen was the most stable marker associated with RFS. In the validation cohort, adding fibrinogen, HCIP, or hemorrhage/coagulation components produced modest incremental discrimination and lower prediction error beyond clinical variables.

HCIP identifies a clinically accessible hemorrhage-coagulation state associated with CD163/HO-1-enriched heme-processing macrophage features and coagulation-associated immune remodeling in colorectal cancer. Fibrinogen remained the most practical single coagulation marker, whereas HCIP provided a biologically interpretable composite phenotype linking local hemorrhagic pathology, systemic coagulation activation, and recurrence risk.

This study aimed to characterize the immune profile of neonates with Kasabach-Merritt phenomenon (KMP) and to identify clinical features linked to severe thrombocytopenia in these patients.

This multicenter retrospective study included neonates diagnosed with KMP based on established criteria. The peripheral blood lymphocyte subsets, complement levels, and humoral immunity were compared between KMP neonates and controls. KMP neonates were further divided into severe and non-severe groups based on whether the platelet count was <20 × 10⁹/L. Clinical data and treatment outcomes were compared between the two groups, and multivariate analysis was performed to identify independent factors associated with severe thrombocytopenia.

A total of 32 KMP neonates were included (13 in the severe group and 19 in the non-severe group). Compared with controls, KMP neonates had reduced CD3⁺CD4⁺ and CD3^-CD19⁺ proportions and lower IgG levels (all P < 0.05). The most common type of KHE lesion in KMP neonates was superficial + mixed (24/32, 75.00%), with a median maximum diameter of 68.50 (52.50-87.25) mm and a platelet count of 41.50 (17.25-48.75) × 10⁹/L. Of the KMP neonates, 25 achieved complete remission (78.1%), 4 achieved partial remission (12.5%), and 3 had no remission (9.3%). Compared to the non-severe group, the severe KMP group had larger diameters. The severe group also had lower CD3+CD4+ proportions, and significantly higher levels of lymphocytes percentage (L%), PCT, CKMB, and ferritin, along with prolonged APTT (P < 0.05). No significant difference in prognosis was observed between the two groups (P > 0.05). Multivariate regression analysis identified prolonged APTT and elevated ferritin as independently associated with severe thrombocytopenia in KMP.

Neonates with KMP showed immunological abnormalities, including decreases in helper T cells and B cells. Prolonged APTT and elevated ferritin were identified as independent risk factors for severe thrombocytopenia in KMP.

To evaluate the prognostic impact of Grade Group (GG) 5 following permanent seed implantation brachytherapy-based trimodality therapy.

We retrospectively analyzed 352 men with National Comprehensive Cancer Network high-risk prostate cancer treated with trimodality therapy (low-dose-rate brachytherapy, external beam radiation therapy, and androgen deprivation therapy [ADT]) between 2003 and 2019. Staging included computed tomography, magnetic resonance imaging, and bone scintigraphy. Endpoints were biochemical recurrence (BCR; Phoenix definition), overall survival (OS), and cancer-specific survival (CSS). Survival outcomes were assessed using the Kaplan-Meier and log-rank tests. Multivariable Cox proportional hazards models, adjusting for prostate-specific antigen, clinical stage, duration of ADT, and biologically effective dose (BED), evaluated the association between GG5 and BCR. Clinical recurrence patterns post-BCR were assessed.

Median follow-up was 8.2 years (interquartile range [IQR] 5.4-10.0); median BED was 214 Gy (IQR 207-222). Among three study groups (GG1-3, GG4, and GG5), GG5 (n = 106) exhibited significantly lower BCR-free survival (p = 0.002) and CSS (p = 0.045), while OS was comparable (p = 0.3). GG5 remained an independent risk factor for BCR after the adjustment (vs. GG1-4, hazard ratio 2.78, 95% confidence interval 1.60-4.82, p < 0.001). GG5 recurrences predominantly involved the pelvic nodes or bone, whereas local and visceral metastases were infrequent.

This study demonstrated that GG5 is an independent predictor of BCR and cancer-specific mortality after trimodality therapy. Despite high BED, the propensity for nodal and bone metastases suggests the need for intensified staging and systemic therapy to optimize outcomes for GG5 disease.

Myxofibrosarcoma (MFS) is a rare form of soft tissue sarcoma, distinguished by its local aggressiveness and a high recurrence rate. However, cases involving the lower leg and progressively affecting large segments of the tibia are infrequently reported in the literature. In this study, we report the case of a 76-year-old patient with MFS of the right calf, which progressively affected critical-sized tibial defects. The patient underwent surgical resection followed by reconstruction using an individualized three-dimensional (3D)-printed prosthesis, which preserved both the knee and ankle joints.

This report describes the case of a 76-year-old Chinese woman with MFS of the right calf, which progressively invaded the mid-tibia. She underwent wide tumor resection and reconstruction using a customized 3D-printed prosthesis that preserved both the tibial epiphysis and ankle joint. The procedure successfully preserved the entire articular surface, providing a viable alternative for maintaining both the function and integrity of the affected limb. The patient maintained normal knee joint function, with no evidence of recurrence or metastasis observed during the 2-month postoperative follow-up.

Reconstruction of critical-sized tibial defects with a customized 3D-printed non-cemented prosthesis after resection of a large MFS tumor demonstrated excellent mechanical stability during the early follow-up period in this knee and ankle joint-preserving procedure. Further investigation into the durability and long-term complication rates is necessary before this approach can be incorporated into routine clinical practice.

The diagnostic image quality of positron emission tomography (PET) acquisitions strongly depends on the administered radiotracer activity and acquisition time. However, keeping these variables as low as possible is desired to reduce patient radiation exposure and the radiopharmaceutical related costs of PET examinations. PETfectior is an artificial intelligence-based software that processes PET scans and increases the signal-to-noise ratio, obtaining high-quality images from low-count-rate images. In this study, we perform an initial clinical validation of PETfectior on images acquired with half of the counting statistics required to meet the most recent European Association of Nuclear Medicine quantitative standards for¹⁸F-FDG PET, evaluating lesion detectability, quantitative accuracy and image quality. 258 patients referred for¹⁸F-FDG PET/computed tomography (CT) were prospectively included. The standard-of-care scans (100% scans) were acquired and reconstructed according to EARL standards 2. Besides, half-counting-statistics versions of these images were obtained from list-mode data and processed with PETfectior (50% + PETfectior scans). All the oncologic lesions were segmented on both versions of the PET/CT images either manually or automatically and lesion detectability was evaluated. The SUV_maxof the lesions was measured and the quantitative concordance of 50% + PETfectior and 100% images was evaluated. Subjective image quality was visually assessed by two experienced physicians. 1649 lesions were detected in a total of 198 studies. The 50%+ PETfectior images showed high sensitivity for lesion detection (99.9%) and only one false positive was detected. Quantitative concordance of SUV_maxmeasured on 100% and 50% + PETfectior images was within ±12.5% (95% limits of agreement), with a bias of -1.01%. No difference in image quality between 50% + PETfectior and 100% images was found. We conclude that PETfectior can safely be used in the clinical practice with¹⁸F-FDG at half counting statistics, with high sensitivity and specificity, low quantitative bias and high subjective image quality, at least for the scanners evaluated in this study.