To investigate sex-related differences in the association of body fat distribution with hepatic insulin clearance (HIC) in type 2 diabetes mellitus (T2DM), determining whether HIC associates more strongly with static hepatic steatosis or visceral adiposity.

We retrospectively analyzed 234 inpatients with T2DM (146 men, 88 women). Regional and ectopic fat were quantified via deep-learning computed tomography (CT). HIC was derived from oral glucose tolerance tests. Multivariable regression and propensity score matching (PSM) identified independent HIC determinants.

Men had larger visceral adipose tissue (VAT) areas; women had higher hepatic fat. VAT was independently associated with systemic insulin resistance. After adjusting for insulin resistance, VAT was positively associated with HIC in women (β = 0.395, P = 0.008), but not men (β = -0.047, P = 0.636). These patterns persisted in the PSM cohort (P for interaction = 0.025), even after additional adjustment for insulin resistance (P for interaction = 0.07). CT-assessed hepatic fat showed no independent association with HIC.

The association between visceral adiposity and HIC is sex-related, with preserved adaptation in women but not in men. Visceral adiposity is more strongly associated with clearance dynamics than static hepatic steatosis, improving the pathophysiological characterization of T2DM.

Hypomagnesemia, defined as low serum/plasma magnesium concentration, is a highly prevalent yet underrecognized electrolyte disorder with extensive clinical, metabolic, and nutritional implications. This review provides an updated synthesis of magnesium physiology, dietary determinants, homeostatic regulation, diagnostic challenges, and therapeutic strategies, with particular emphasis on recent meta-analyses and large-scale epidemiological evidence linking hypomagnesemia to multisystem disease.

Accumulating evidence has shown consistent associations between low serum or dietary magnesium and increased risk of cardiometabolic disorders (hypertension, type 2 diabetes mellitus, metabolic syndrome, and cardiovascular disease), neuropsychiatric conditions (migraine, depression, cognitive impairment, and dementia), osteoporosis, immune dysregulation, and adverse outcomes in hospitalized, critically ill, and chronic kidney disease patients. Mechanistic studies have clarified the roles of TRPM6/7 channels, tight junction claudins, and basolateral magnesium transporters in intestinal and renal magnesium handling, elucidating pathways underlying both inherited and acquired deficiencies. Research has also highlighted the contribution of modern dietary patterns, food processing, mineral-depleted drinking water, medication use (notably proton pump inhibitors, diuretics and chemotherapeutic agents), and gut microbiome alterations to widespread subclinical deficiency. Meta-analyses of RCTs indicate that magnesium supplementation confers modest but clinically relevant improvements in blood pressure, glycemic control, inflammatory markers, endothelial function, migraine frequency, and depressive symptoms, particularly in individuals with baseline hypomagnesemia. However, serum magnesium remains an insensitive biomarker of total body magnesium status, and consensus on optimal diagnostic thresholds and replacement strategies is lacking.

Magnesium deficiency contributes to a wide spectrum of multisystem disorders, and is driven by dietary insufficiency, gastrointestinal and renal losses, medication use, chronic disease, and altered microbiome function. Meta-analytic evidence supports its role as a modifiable risk factor across cardiovascular, metabolic, neurological, skeletal, and immune disorders. Dietary modification, optimized supplementation, and correction of underlying causes of deficiency remain central to management. Future research should focus on improved diagnostic tools, personalized dosing approaches and long-term outcomes of magnesium repletion. Enhancing clinical awareness and integrating magnesium evaluation into routine care may reduce the growing burden of hypomagnesemia.

Paranasal sinus tumors are rare malignancies that are known to be aggressive with poor outcomes. Data are limited regarding factors associated with survival and prognosis. In this study, we investigated factors associated with survival for both patients with squamous cell carcinoma (SCC) and adenocarcinoma (AC).

The Surveillance, Epidemiology and End Results (SEER) data was utilized from the years 2000 to 2019. Kaplan-Meier survival analysis and Cox regression modeling were employed to evaluate the relationship between several co-variates and overall survival (OS) and disease-specific survival (DSS) among patients with SCC and AC.

A total of 5276 patients with SCC and 5222 patients with AC were included. Compared to SCC patients, those with AC were younger and presented with less differentiated and more advanced tumors (p < 0.0001). The median OS for SCC was 203 months compared to the 56 months in patients with AC (p < 0.0001). Primary site, race, stage, grade, and treatment modalities utilized were significantly predictive of OS and DSS in SCC patients in univariate analysis. Among AC patients, we found stage, grade, and treatment modalities to be significantly predictive of OS and DSS in univariate analysis. For SCC, stage (p < 0.001), primary site (p < 0.001), and treatment (p < 0.001) were significant predictors of survival on multivariate analysis. Specifically, nasal SCC was found to have improved survival compared to other sites. For AC, stage (p < 0.001) and treatment (p < 0.001) were significant predictors of survival on multivariate analysis. For both SCC and AC, treatment with both radiation and surgery had improved survival compared to radiation alone (p < 0.0001).

SCC and AC of the paranasal sinus and nasal cavity portend an overall poor prognosis with limited survival. Our study effectively elucidates factors associated with survival which may be useful in treatment and counseling patients with paranasal sinus AC and SCC.

Although the impact of increased time to treatment initiation (TTI) on outcomes for patients with oropharyngeal squamous cell carcinoma (OPSCC) has been well-studied, a deeper understanding of the mechanisms underlying delay in patients with human papillomavirus (HPV)-negative OPSCC is lacking in the current literature.

To assess differences in sociodemographic factors and treatment timelines between patients with HPV-negative OPSCC with shorter versus. longer TTI.

Patients treated for HPV-negative OPSCC at a single academic institution between 2013 and 2023 were retrospectively identified via chart review and dichotomized by the cohort median TTI (53.5 days; defined as the time from biopsy to first treatment initiation). Clinical timelines between delayed and nondelayed patients were compared using descriptive statistics and Mann-Whitney U testing. Independent predictors of delayed TTI (> 53.5 days) were evaluated using multivariate logistic regression modeling, with adjusted odds ratios (aORs) and 95% confidence intervals reported.

Seventy-six patients were identified. On multivariable analysis, male sex (aOR 3.28; 95% CI 1.02-10.49), unmarried status (aOR 5.96; 95% CI 1.36-26.07), primary chemoradiation versus surgery (aOR 0.25; 95% CI 0.07-0.85), and biopsy available before arrival (aOR 4.08; 95% CI 1.32-17.36) were independently and significantly (p< 0.05) associated with delayed treatment initiation. Treatment timeline analysis revealed that both the interval from biopsy to referral and the interval from PET scan to treatment initiation differed significantly between delayed and nondelayed patients (p< 0.05).

Primary nonsurgical treatment and lack of social support were found to be independently associated with treatment delay in patients with HPV-negative OPSCC. These findings highlight opportunities for improving the care of HPV-negative OPSCC at the specialty level.

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare type of cutaneous lymphoma lacking standardized treatments. Consequently, patient outcomes vary significantly.

This study explored the clinical characteristics and prognostic factors of 205 SPTCL patients from 2000 to 2021 in the Surveillance, Epidemiology, and End Results (SEER) database.

Overall survival (OS) at 1, 3, and 5 years were 78.3%, 75.7%, and 66.4%, respectively. Patients diagnosed after 2008 (possibly excluding the γ-δ subtype) (HR = 0.197, 95% CI = 0.106-0.364, p = 0.000) and Asian or Pacific Islanders (HR = 0.210, 95% CI = 0.049-0.902, p = 0.036) were independent predictors of favorable survival, whereas age 50-60 years (HR = 3.213, 95% CI = 1.357-7.607, p = 0.008) and age > 60 years (HR = 5.039, 95% CI = 2.327-10.911, p = 0.000) were independently associated with poor survival. Patients who received radiotherapy alone exhibited a significantly lower hazard risk compared to those receiving no chemotherapy or radiation (HR = 0.216, 95% CI = 0.048-0.983, p = 0.048). No statistically significant differences in prognosis were observed between patients who received no chemotherapy or radiation and those who received either chemotherapy alone (HR = 1.276, 95% CI = 0.644-2.529, p = 0.485) or radiochemotherapy (HR = 1.283, 95% CI = 0.463-3.558, p = 0.632). These associations persisted after IPTW adjustment, with age, race, year of diagnosis, and treatment remaining independent predictors of OS in SPTCL.

The Ann Arbor staging was not suitable for SPTCL. Radiotherapy represents an appropriate therapeutic option for patients with single or localized skin lesions. No statistically significant differences in prognosis were observed between patients who received no chemotherapy or radiation and those who received either chemotherapy alone or radiochemotherapy. This finding suggests that immunomodulatory agents may be preferable to cytotoxic therapy as initial treatment for SPTCL, an inflammatory lymphoma.

Immune cells have been linked to the initiation and progression of tumors, and their presence is often used to predict disease prognosis. However, when it comes to bladder urothelial carcinoma (BLCA), there has not been a comprehensive investigation into the function and prognostic value of different immune cell types.

We integrated data from more than 2300 BLCA patients across 14 public datasets. Then we analyzed the quantity of 170 different immune cell signatures using the ssGSEA algorithm. Through meta-analysis and univariable Cox analysis, we identified prognosis-associated immune cells and established an immune cell related prognostic signature (IRPS). We then conducted survival analyses to observe the differences in survival across different IRPS-risk groups. Furthermore, based on the DEGs associated with IRPS, we screened for potential targeted therapeutic agents. Finally, we integrated IRPS with clinical features to establish a comprehensive prognostic index (ICPI).

Our analysis identified 90 immune cell types that were particularly relevant to BLCA. Then we constructed and validated the IRPS, with high IRPS significantly associated with longer overall survival (HR = 0.73, 95% CI, 0.71-0.76, p < 0.001). In two independent immunotherapy cohorts (IMvigor210 and GSE78220), patients with high IRPS demonstrated significantly prolonged survival following immune checkpoint inhibitor treatment (p = 0.035, p = 0.019). Several candidate drugs targeting IRPS were identified. The ICPI, developed by integrating IRPS with clinical features, also demonstrated enhanced accuracy in prognostic analysis.

This study successfully developed and validated a prognostic signature (IRPS) based on comprehensive immune cell infiltration analysis, along with its integrated index (ICPI). IRPS/ICPI serves as an effective tool for predicting BLCA patient prognosis and guiding immunotherapy strategies, while also aiding in the identification of patient populations likely to benefit from immunotherapy.

Objective: To systematically summarize the research progress of clinical trials on breast cancer drugs in China from 2011 to 2022, as well as provide an overview of the marketed drugs. The goal is to offer data and decision-making evidence for relevant departments. Methods: Based on the registration database of the China National Medical Products Administration's Clinical Trial Registration and Information Disclosure Platform, as well as data from the domestic and imported drug query systems, an analysis was conducted on clinical trials of breast cancer drugs, including information on investigational drugs and marketed drugs from January 1, 2011, to December 31, 2022. The study compared differences between Chinese and foreign enterprises in terms of trial scope, trial phases, number of treatment lines, drug types, and mechanisms of action. Results: From 2011 to 2022, a total of 401 clinical trials for breast cancer were registered in China, accounting for 8.0% of the country's overall anti-tumor clinical trials (401/5 011), with 304 trials (75.8%) initiated by domestic enterprises. Over the past decade, clinical trials for breast cancer showed fluctuating growth, reaching a peak of 84 trials in 2020. These trials involved 254 drugs, with 156 (61.4%) being original drugs and 174 (68.5%) being targeted therapies. The most focused targets included human epidermal growth factor receptor 2 (HER-2), cyclin-dependent kinases 4/6 (CDK4/6), and estrogen receptors (ER). There are 50 drugs targeting HER-2 (28.7%), 35 targeting CDK4/6 (20.1%), and 31 targeting ER (17.8%). During the period from 2011 to 2022, a total of 15 drugs for treating breast cancer were approved and launched in China, covering 19 indications. Among these, 7 indications are for adjuvant or neoadjuvant therapy of early-stage breast cancer, and 12 indications are for advanced breast cancer. Conclusions: Substantial achievements have been made in the development of new breast cancer drugs in China from 2011 to 2022. However, there remains a significant gap in the innovation capabilities of domestic pharmaceutical companies compared to international counterparts in the field of breast cancer. Future efforts should be directed towards strengthening research and development in breast cancer, exploring new target points, and investigating combination therapy mechanisms.

Objective: To investigate the preoperative diagnostic value of ultrasound-guided fine-needle aspiration biopsy wash-out fluid (FNA-CT) in medullary thyroid carcinoma (MTC) with mildly elevated serum calcitonin levels. Methods: 267 patients with MTC diagnosed in Tianjin Cancer Hospital between Jan 2015 and Jan 2024 were enrolled in the study. Based on serum calcitonin, patients were divided into two groups:＞100 ng/L and 10-100 ng/L. Sonographic features, clinicopathological characteristics and prognostic outcomes were evaluated between the two groups. The diagnostic efficacy of serum calcitonin and FNA-CT in MTC and non-medullary thyroid carcinoma with slightly high serum calcitonin were evaluated. The best cutoff values of serum calcitonin and FNA-CT were calculated by subject operating characteristic curve (ROC). The diagnostic efficacy was analyzed for MTC with mildly elevated serum calcitonin according the best cut off points. Results: Compared to the >100 ng/L group, MTC patients with serum calcitonin 10-100 ng/L exhibited distinct ultrasonographic features: taller-than-wide shape, non-adjacent to thyroid capsule, less vascularity, and CACA-TIRADS 4 (all P＜0.05). Clinicopathologically, the serum calcitonin 10-100 ng/L group demonstrated single focus rather than multifocality, smaller tumor size, higher prevalence of microcarcinoma, a lower degree of local invasion, earlier tumor stages (T stage, N stage, TNM stage), smaller extent of thyroidectomy and lymphadenectomy and lower diagnostic accuracy of FNA (all P＜0.05). The group also showed higher biochemical cure rate (90.0% and 54.2%)and lower rates of biochemical recurrence (5.5% and 23.1%) and tumor recurrence (3.6% and 22.6%, P＜0.001). Among MTC with serum calcitonin 10-100 ng/L, the median of serum calcitonin levels were 40.0 ng/L (19.5, 65.8 ng/L) for MTC vs. 16.6 ng/L (13.2, 20.8 ng/L, P＜0.001) for non-medullary thyroid carcinoma. The median of FNA-CT were 2 000.0 ng/L (1 334.0, 2 000.0 ng/L) vs. 0.8 ng/L (0.5, 2.0 ng/L, P＜0.001). The best cutoff points were 22.9 ng/L for serum calcitonin and 58.7 ng/L for FNA-CT. The sensitivity, specificity, negative predictive value, positive predictive value and the area under curve (AUC) were 67.3%, 82.9%, 65.4%, 61.2% and 0.829 (95% CI: 0.731-0.903) at the best cutoff point of 22.9 ng/L for serum calcitonin. The sensitivity, specificity, negative predictive value, positive predictive value and AUC were 98.2%, 97.6%, 97.61%, 98.1% and 0.998 (95% CI: 0.989-0.998) at the best cutoff point of 58.7 ng/L for FNA-CT. Conclusions: MTC with slightly elevated serum calcitonin commonly correlates with an early-stage disease. FNA-CT has demonstrated near-perfect diagnostic performance and improved the early detection in this population.

Objective: The National Central Cancer Registry estimates the cancer diseases burden in China in 2024. Methods: We incorporated the surveillance data from 919 cancer registries of year 2019 and the longitudinal surveillance data from 106 registries during 2010 to 2019. We estimated the age-standardized incidence (ASIR) and mortality rates (ASMR) of overall and 23 major cancers in China in 2024 using the age-period-cohort model, stratified by sex and area. The age-standardized incidence (ASIRC) and mortality (ASMRC) rates by Chinese population were calculated based on the age structure of the population from the national census in 2000. The age-standardized incidence (ASIRW) and mortality (ASMRW) rates by World population were calculated using Segi's world standard age structure. Results: In 2024, there were approximately 5 150 600 new cancer cases in China (2 672 000 for males and 2 478 600 for females), with an ASIRW of 207.70 per 100 000 (215.71 per 100 000 in urban areas and 193.74 per 100 000 in rural areas). The estimated number of cancer deaths in China was 2 582 200 (1 640 500 for males and 941 700 for females), with an ASMRW of 90.90 per 100 000 (87.34 per 100 000 in urban areas and 96.27 per 100 000 in rural areas). When comparing between different sexes, the cancer ASIRs for both males and females were relatively close. The ASMRs for males were 1.9 times that of females. When comparing among different areas, the crude cancer incidence rate in rural areas was higher than that in urban areas, while the ASIRs were lower than that in urban areas. Both the crude mortality rate and the ASMRs in rural areas were higher than those in urban areas. Among different cancer types, lung cancer ranked first in terms of both incidence and mortality, with 1 175 900 new cases and 743 300 deaths, accounting for 22.8% and 28.8% of all cancer cases and deaths, respectively. In both males and females, the ASIRs and ASMRs of liver, stomach and esophageal cancer in rural areas were higher than those in urban areas, while the ASIRs and ASMRs of colorectal cancer in urban areas were higher than those in rural areas. The ASIRs and ASMRs of cervical cancer in rural areas were higher than those in urban areas. The disease burden of prostate cancer and breast cancer in urban areas was higher than that in rural areas. The incidence and mortality rates of lung cancer ranked first in most provinces of China. The incidence rate of nasopharyngeal cancer was relatively high in Guangxi, Guangdong, Hainan and Jiangxi. Renal cancer was more prevalent in northern regions, and prostate cancer was more common in economically developed areas. The incidence rate of thyroid cancer ranked second in Zhejiang, Fujian and Xinjiang. The incidence rates of esophageal cancer and cervical cancer were significantly lower in Beijing, Tianjin, Shanghai and Guangdong. Conclusions: The overall burden of cancer in China remains significant. Different regions should formulate targeted prevention and control strategies based on the characteristics of regional cancer disease burdens.

Esophageal cancer is a malignancy to cause heavy global disease burden, the research of traditional risk factors, such as smoking, alcohol use, can not fully explain the heterogeneity of region specific incidence and molecular diversity of esophageal cancer. Traditional risk factor research usually focus on isolated effects of individual factor, neglecting interaction of multi factors on subtypes of esophageal cancer, and the exposure assessment of traditional risk factor research can not quantify the actual biological doses of potential risk factors, such as micronutrient deficiency and region-specific environmental pollutant exposure. Advancements in multi-omics technologies (including exposomics and genomics) have identified emerging risk factors, which have not been formally classified as established risk factors for esophageal cancer by International Agency for Research on Cancer, but revealed the non-traditional risk factors (potential carcinogenic mechanisms or population-level associations) of esophageal cancer in the past decade, including oral microorganism dysbiosis, perfluoroalkyl and polyfluoroalkyl substance exposures, and circadian disruption. This paper systematically summarizes the progress in epidemiological research of these factors to provide novel perspectives for the precise prevention and control of esophageal cancer.