Objective: To analyze the hospitalization expenditures and their temporal trends in patients with nasopharyngeal carcinoma (NPC), and evaluate the associated economic burden and influencing factors. Methods: A random sampling survey was conducted in newly diagnosed NPC patients undergoing curative therapy in a grade Ⅲ cancer hospital in Southern China from January 2019 to December 2023 to obtain their hospitalization cost data, the patients with recurrence, metastasis, severe complications or receiving no radical therapy were excluded. The collected data included basic demographics, tumor characteristic, treatment way, payment method, total hospitalization expenditure, and their composition. The primary outcome was the median hospitalization expenditure per case (adjusted to 2023 values using the Consumer Price Index). Univariate and multivariate generalized linear models were used to identify factors associated with hospitalization expenditures. The annual cost composition and temporal trends were analyzed. Results: A total of 788 NPC patients were finally included with an age of diagnosis of (47.0±11.7) years, in whom 598 (75.9%) were from Southern China, 584 (74.1%) were men, and 716 (90.9%) were at advanced stage. The M(Q₁, Q₃) hospitalization expenditure per case was 146 289 (125 083, 178 056) yuan. The median expenditures in 2019, 2020 and 2021 were 150 718, 151 811 and 157 463 yuan, respectively, and the median expenditures decreased to 139 696 yuan in 2022 and 134 621 yuan in 2023. Regarding cost composition, the expenditure for radiotherapy was highest (83 430 yuan, 59.7%), followed by the expenditure for medication (26 580 yuan, 19.0%). Multivariable generalized linear model analysis showed that the median hospitalization expenditure (150 045 yuan) was higher in patients with commercial insurance or public funding than in those with urban resident basic medical insurance (144 524 yuan) (aOR=1.11, 95%CI: 1.06-1.16, P<0.001). Patients in advanced stage had higher expenditures (149 342 yuan) compared with those in early stage (114 476 yuan) (aOR=1.11, 95%CI: 1.03-1.19, P=0.002). Patients receiving comprehensive treatment incurred higher expenditures (148 573 yuan) compared with those receiving radiotherapy alone (99 727 yuan) (aOR=1.33, 95%CI: 1.21-1.47, P<0.001). The median hospitalization expenditures of patients in 2022 (139 696 yuan) and 2023 (134 621 yuan) were lower than those in 2019 (150 718 yuan) (aOR=0.93, 95%CI: 0.88-0.99; aOR=0.87, 95%CI: 0.82-0.93, both P<0.05). Conclusions: The median hospitalization expenditure per case in NPC patients was high with a slight decreasing trend in recent years. Payment method, clinical stage, treatment way, year of hospitalization were the main factors influencing the hospitalization expenditure.

The study explored patient experiences of the Call for a Kit (CFAK) intervention, a community-based initiative designed to improve bowel cancer screening uptake and examined the mechanisms that may support participation among non-responders.

A convergent parallel mixed-methods design was employed, combining quantitative surveys and qualitative interviews.

The evaluation was conducted in general practices across Lancashire and South Cumbria, Northwest England, where CFAK clinics were delivered by an external health promotion team based within the Community Voluntary Services. These clinics target practices with low screening uptake.

A total of 113 CFAK attendees aged 54 and above, and who had missed their most recent screening invitation, completed a patient experience survey. 12 participants were purposively sampled for follow-up interviews.

Statistical analyses examined associations between patient experience and screening behaviours, including kit ordering and intention to complete the screening kit. Thematic analysis explored barriers and facilitators to participation, as well as experiences of CFAK clinics.

Patient experience scores were significantly higher among women than men and were positively associated with intention to complete the kit, though not with kit ordering. Qualitative findings indicated that CFAK addressed key barriers such as low awareness, confusion and emotional discomfort by providing personalised education, reassurance and culturally sensitive support. Participants particularly valued the relational aspects of the intervention, including the face-to-face delivery and communication in preferred languages.

CFAK clinics appear to enhance psychological capability and motivation for bowel screening by offering tailored, inclusive and supportive care. These findings highlight the value of patient-centred approaches in addressing inequalities in cancer screening and offer insights for the design of future community-based interventions.

Despite its advantages over open and laparoscopic approaches, robotic liver parenchymal transection is difficult because of the lack of a standardized method. Saline-linked cautery (SLiC) method during robotic liver parenchymal transection was previously reported. To verify the safety and practicality of the SLiC method, the perioperative outcomes of laparoscopic liver resection (LLR) and robotic liver resection (RLR) were compared using propensity score matching (PSM).

LLRs and RLRs at our institution were analyzed from 2017 to 2024. Liver parenchymal transection of LLRs was performed using laparoscopic coagulating shears or cavitron ultrasonic surgical aspirator, and that of RLRs was performed using the SLiC method. Patient characteristics, surgical factors, and tumor factors were adjusted using PSM. Perioperative outcomes were compared between the LLR and RLR groups.

LLR was performed in 145 patients and RLR in 129. Before PSM, tumor size was significantly larger in LLRs than in RLRs, whereas the rate of repeat hepatectomy was significantly higher. Blood loss was significantly lower in RLRs. After PSM, 94 cases were matched and analyzed. RLR substantially reduced intraoperative blood loss (63 mL in LLR vs. 15 mL in RLR, p < 0.01). Multivariate analysis for a higher amount of blood loss showed that the RLR was an independent risk-reducing factor.

Comparable perioperative outcomes were observed between RLRs and LLRs, indicating that RLR can be performed safely and practically. The SLiC method is one of the preferred techniques for safer RLR with less blood loss.

It is unclear whether patients with cancer continue to benefit from antithrombotic therapy (ATT) during the last phase of life. We estimated the incidences of ATT discontinuation, bleeding, and venous thromboembolic (VTE) and arterial thromboembolic (ATE) events among patients with cancer during the last phase of life.

We included patients aged ≥18 years with cancer during the period 2018 to 2022 at the time a reimbursement claim for general practitioner (GP) palliative care was made. We manually identified ATT discontinuation, along with reasons, and the incidences of bleeding events, VTE events, and ATE events in free-text reports of routine primary care consultations until death.

Among the 2,860 included patients, 32.5% used ATT at the index date. The median follow-up was 43 (interquartile range [IQR] 14-190) days for ATT users and 42 (IQR 13-149) days for nonusers. During follow-up, 22.1% of ATT users discontinued ATT, with a median of 8 (IQR 3-26) days before death. The most common reason for discontinuation was recognition of the terminal phase (22.9%). Bleeding occurred for 28.5% (95% CI, 25.7%-31.5%) of ATT users and 22.0% (95% CI, 20.2%-23.9%) of nonusers. Venous thromboembolic events occurred for 3.1% (95% CI, 2.2%-4.4%) of ATT users and 3.0% (95% CI, 2.3%-3.9%) of nonusers, and ATE events occurred for 2.5% (95% CI, 1.7%-3.7%) of ATT users and 1.9% (95% CI, 1.4%-2.6%) nonusers.

One-third of patients with cancer used ATT at the initiation of GP palliative care, with most continuing treatment until death or discontinuing shortly before death. Bleeding events largely outnumbered ATE and VTE events among both ATT users and non-users. These findings provide new insights into ATT management by GPs and inform future research on optimizing ATT use for patients with cancer during the last phase of life.

A better understanding of the association of isolation with preventive care uptake and material deprivation-2 potential drivers of worse health outcomes among isolated individuals-could inform health policy to mitigate the health harms of isolation.

We analyzed data from the 2022 Behavioral Risk Factor Surveillance System. Our exposures were self-reported social isolation and physical isolation (assessed from transportation barriers). We examined the association of each form of isolation with indicators of material deprivation and with the uptake of 6 recommended preventive care services (COVID, influenza, and pneumococcal vaccinations, and cervical, colorectal, and breast cancer screenings).

Our population included 281,592 adult respondents; 82,816 (31.9%) reported social isolation and 18,181 (8.2%) reported physical isolation. In unadjusted analyses, each form of isolation was associated with reduced uptake of preventive care services. After multivariate adjustment, social isolation remained associated with reduced uptake of 2 services-breast cancer screening (adjusted odds ratio [AOR] = 0.70; 95% CI, 0.65-0.76) and colorectal cancer screening (AOR = 0.91; 95% CI, 0.85-0.97)-and physical isolation remained associated with reduced uptake of 3 services-influenza vaccination (AOR = 0.89; 95% CI, 0.82-0.97), breast cancer screening (AOR = 0.57; 95% CI, 0.49-0.66), and colorectal cancer screening (AOR = 0.81; 95% CI, 0.71-0.93).

Social isolation and physical isolation are associated with reduced preventive care use, but adjustment for material deprivation substantially attenuates these associations. Policies to foster social connectedness and alleviate transportation barriers may improve health outcomes, but intervention on socioeconomic factors will likely also be necessary.

Breast cancer surgery urgently requires a rapid and objective intraoperative diagnostic strategy, as conventional frozen-section pathology depends on time-consuming staining and subjective interpretation, limiting timely surgical decision-making. However, existing label-free microscopic imaging approaches exclude conventional pathological information and lack diagnostic power. To overcome these limitations, a multimodal fusion framework based on unstained multi-angle orthogonal polarization micro-imaging (OPMI) and bright-field micro-imaging (BFMI) was proposed for rapid intraoperative breast cancer diagnosis. By superimposing and differencing multi-angle polarized images, optical contrast of anisotropic collagen fibers was markedly enhanced without staining, enabling objective visualization of collagen morphology and spatial alterations associated with malignancy. Local radial alignment and increased density of collagen fibers corresponding to invasive progression were identified. A dual-encoder fusion network integrating global and local feature representation improved lesion structure and boundary delineation. The method achieved 91.83% accuracy and area under the curve (AUC) of 0.9295, outperforming unimodal and bimodal approaches, offering a promising label-free intraoperative decision-support strategy.

While the clinical value of magnetic resonance imaging (MRI)-ultrasound fusion-targeted prostate biopsy (TB) for index lesions (ILs) has been established, the utility of TB for non-index lesions (nILs) remains unclear. We evaluated the diagnostic benefit of combining TB for nILs (nIL-TB) with TB for ILs (IL-TB) in patients with multiple MRI-identified lesions.

A total of 304 patients with multiple Prostate Imaging-Reporting and Data System (PI-RADS)≥3 lesions who underwent IL-TB, nIL-TB, and systematic biopsy (SB) were included. One or 2 nILs per case, defined as lesions with lower PI-RADS category or smaller size than the IL, were targeted. Detection rates of grade group (GG) ≥2 and GG 1 cancer were compared between different biopsy strategies, and the added values of SB and nIL-TB to IL-TB were assessed. Risk factors for missing GG≥2 cancer in IL-TB and detecting it in nIL-TB were explored using multivariable analysis.

Detection rates of GG≥2 cancer were 55.9% in IL-TB alone, 70.4% in IL-TB+SB, and 68.8% in IL-TB+nIL-TB, revealing no significant difference in the added value between SB and nIL-TB(14.5% vs.12.8%, p = 0.398). GG 1 cancer was detected more frequently in IL-TB+SB than in IL-TB+nIL-TB(11.5% vs.6.6%, p = 0.004). Small IL volume and IL confined to the transition zone were independent predictors of missing GG≥2 cancer in IL-TB and detecting it in nIL-TB (p = 0.002, odds ratio[OR]=3.07; p = 0.018, OR=2.41).

Combining IL-TB and nIL-TB provides a comparable detection rate of GG≥2 cancer with fewer cores than combined biopsy with IL-TB and SB and avoids the detection of GG 1 cancer. nIL-TB may be an alternative to SB in patients with multiple MRI-identified lesions.

Objective: To exploit the elevated glutathione (GSH) levels in the tumor microenvironment and investigate the therapeutic efficacy of a novel glutathione-responsive apurinic/apyrimidinic (AP) site captor, Probe-NEt, against anaplastic thyroid cancer (ATC). Methods: Fluorescence imaging compared Probe-NEt uptake and activation in normal thyroid (Nthy ori 3-1), ATC (THJ-16T, CAL-62), and lung cancer (H1299) cells. Half maximal inhibitory concentration (IC₅₀) values were determined by cytotoxicity assays; DNA damage was evaluated using appropriate assays. Flow cytometry analyzed cell cycle distribution and apoptosis following treatment with low (5 μmol/L) or high (20 μmol/L) Probe-NEt concentrations. BALB/c nude mice bearing subcutaneous ATC xenografts received low (0.025 mg) or high (0.05 mg) dose injections. Tumor volumes were monitored; HE staining assessed biosafety in major organs; immunohistochemistry detected apoptosis-related protein expression. Results: ATC cells demonstrated significantly higher Probe-NEt activation than normal thyroid cells. Probe-NEt exhibited selective cytotoxicity (higher IC₅₀ in normal vs. ATC cells; all P＜0.01) with time-dependent characteristics; the selectivity ratio increased from 1.7 at 24 h (62.4 vs. 37.7 μmol/L) to 2.4 at 48 h (32.7 vs. 13.5 μmol/L). Probe-NEt induced DNA damage, G₂/M arrest (THJ-16T: from 5% to 43%; CAL-62: from 19% to 37%), and dose-dependent late apoptosis. In THJ-16T cells, late apoptotic rates rose from 5.49% (control) to 13.95% (low-dose) and 63.43% (high-dose), with viable cells decreasing accordingly (89.42%, 76.01%, 20.45%). CAL-62 cells showed similar trends (16.72%, 40.19%, 69.88%). In vivo, Probe-NEt significantly suppressed tumor growth without hepatorenal toxicity (all P＞0.167). Immunohistochemistry revealed upregulated pro-apoptotic proteins, downregulated anti-apoptotic proteins, and decreased Ki-67 expression. Conclusion: The glutathione-responsive AP site captor Probe-NEt significantly inhibits ATC cell growth, induces G₂/M phase cell cycle arrest, promotes late apoptosis, and exhibits high selectivity and favorable biosafety profiles.

Objective: To investigate the differences in apolipoprotein B mRNA editing enzyme, catalytic polypeptide-like (APOBEC) between human papillomavirus (HPV)-positive and HPV-negative head and neck squamous cell carcinoma (HNSCC) patients, analyze its association with the immune microenvironment and the cGAS-STING pathway, and evaluate its predictive value for immunotherapy efficacy. Methods: Whole-exome sequencing data from HNSCC patients (from September 2017 to March 2020 at the Third Affiliated Hospital of Kunming Medical University) were collected for somatic mutation profiling. APOBEC enrichment scores were calculated and integrated with differentially expressed genes (DEGs) to perform Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis and Gene Set Enrichment Analysis (GSEA). Single-cell RNA sequencing (scRNA-seq) data were utilized to validate the relationship between APOBEC3 expression, immune cell composition, and cGAS-STING module activity. Furthermore, an immunotherapy cohort was analyzed to evaluate the association of APOBEC3 family gene expression with immune checkpoint genes and therapeutic outcomes. Results: APOBEC mutational signatures were prevalent in both HPV-negative and HPV-positive HNSCC patients, but their driving patterns differed significantly: HPV-positive patients were dominated by APOBEC3A mutations, whereas the HPV-negative group exhibited a synergistic effect of multiple family members, including APOBEC3A/3B/3C/3D/3F. Pathway analysis indicated that in HPV-negative HNSCC, APOBEC activity was significantly associated with the enhancement of the cGAS-STING pathway, interferon response, and inflammatory response. Single-cell analysis confirmed that tumors with high APOBEC3 expression had richer immune cell infiltration, and the activities of four functional modules of the cGAS-STING pathway (cGAS-STING, NF-κB, interferon stimulation, and antigen presentation) were significantly upregulated. In the immunotherapy cohort, patients with high APOBEC3 expression exhibited higher expression of immune checkpoint molecules, and their treatment response rates were significantly superior to those in the low-expression group. Conclusions: APOBEC exhibits distinct driving mechanisms in HNSCC depending on HPV status. Its activity is closely related to cGAS-STING pathway activation, enhanced immune infiltration, and improved immunotherapy efficacy, suggesting potential predictive and therapeutic value.

Antibody-drug conjugates (ADCs) have demonstrated groundbreaking progress in the treatment of non-small cell lung cancer (NSCLC). Trophoblast cell surface antigen 2 (TROP2) has emerged as a pivotal therapeutic target, and TROP2-directed ADCs, including Sacituzumab Tirumotecan, Datopotamab Deruxtecan, and Sacituzumab Govitecan have shown substantial antitumor activity and survival benefits in clinical studies. To further standardize the clinical use and safety management of TROP2 ADCs, this expert consensus systematically reviews current evidence regarding their efficacy and safety in NSCLC. Particular emphasis is placed on strategies for the prevention and management of treatment-related adverse events such as mucositis, myelosuppression, and gastrointestinal toxicities, aiming to provide guidance for the rational and safe application of TROP2 ADCs in NSCLC.