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关键词： 恶性肿瘤   发病情况   死亡情况   淮安市淮安区  

摘要： 目的 研究江苏省淮安市淮安区2013—2023年恶性肿瘤发病与死亡情况,为防控肿瘤提供科学合理的依据。方法 整理2013年1月—2023年12月淮安区恶性肿瘤的发病及死亡病例,计算年均化发病率、死亡率。结果 经统计,2013—2023年淮安市淮安区居民的年均恶性肿瘤发病例数为3 360例,年均发病率为369.94/10万,年均标化发病率为196.19/10万,年均累计发病率为21.98%,年均截缩率为321.54/10万。2013—2023年淮安市淮安区居民的年均恶性肿瘤死亡例数为2 307例,年均发病率为225.14/10万,年均标化发病率为112.58/10万,年均累计发病率为12.59%,年均截缩率为147.68/10万;男性恶性肿瘤发病率高于女性,男性恶性肿瘤死亡率高于女性(P<0.05);淮安市淮安区居民恶性肿瘤发病率排名首位的是肺癌,其次为胃癌、肝癌、食管癌。结论 目前淮安市淮安区的恶性肿瘤负重仍然较重,考虑恶性肿瘤的流行特征,加强预防措施,对降低恶性肿瘤发生风险有重要意义。

关键词： 云南松松塔   网络药理学   分子对接   超高效液相色谱-串联质谱法   肿瘤   蛋白互作网络   信号通路   STAT3  

摘要： 目的基于超高效液相色谱-串联质谱法、网络药理学及分子对接技术,系统研究云南松松塔治疗胰腺癌、胃癌、非小细胞肺癌、肝细胞癌及前列腺癌的共性作用机制。方法 通过ADME筛选高活性化合物,利用SwissTargetPrediction预测其靶点;基于GeneCards数据库筛选疾病相关基因;借助STRING在线工具构建蛋白质-蛋白质相互作用(PPI),并通过Cytoscape3.10.3进行可视化分析;通过GO与KEGG分析阐明核心靶点的功能与通路机制;采用分子对接技术评估活性成分与靶点的结合活性。结果从云南松松塔中共筛选出13个活性化合物及662个作用靶点,与5种癌症相关的共同靶点88个;经PPI网络分析获得4个共同核心靶点,分别为STAT3、PIK3CA、SRC与TP53;GO分析得到285个生物学过程、65个细胞组分和74个分子功能条目;KEGG分析提示主要涉及HIF-1、PI3K-Akt等信号通路;分子对接显示核心活性成分7-oxodehydroabieticacid、coniferaldehyde及3',4',5,5',6,7-Hexamethoxyflavone与上述4个核心靶点均具有良好的结合活性。结论 云南松松塔可能通过多靶点、多通路的协同作用,对多种癌症发挥广谱抗肿瘤效应。

关键词： 无膜细胞器   液-液相分离   无序结构域   肿瘤  

摘要： 液-液相分离(liquid-liquid phase separation,LLPS)可以驱动细胞内蛋白质和核酸等生物大分子自发聚集,形成具有液态特性的生物分子凝聚体(biomolecular condensate,BMCs)即无膜细胞器(membrane-less organelles,MLOs).研究发现,关键蛋白的LLPS形成、调控及异常与肿瘤的发生、发展、转移及血管生成等过程密切相关.文章系统综述了LLPS的发生机制,并探讨了其在肿瘤进展不同阶段中的作用,以期为通过干预关键蛋白的LLPS治疗恶性肿瘤提供理论依据.

关键词： 麻醉诱导   低血压   颈动脉   校正血流时间   速度时间积分   模型预测  

摘要： 目的 探讨颈动脉校正血流时间(corrected flow time,FTc)和速度时间积分(velocity time integral,VTI)对胃肠道肿瘤手术患者麻醉诱导后低血压(post-induction hypotension,PIH)的预测价值。方法 以择期行胃肠道肿瘤手术且美国麻醉医师协会(American Society of Anesthesiologists,ASA)麻醉分级为Ⅰ~Ⅲ级的患者为研究对象。所有患者麻醉诱导前采用超声测量颈动脉VTI和FTc,根据麻醉诱导后是否发生低血压将其分为低血压组和非低血压组。采用受试者操作特征(receiver operating characteristic,ROC)曲线评估VTI、FTc及二者联合对PIH的预测效能,并通过多因素Logistic回归分析筛选PIH的影响因素。结果 本研究共纳入115例患者,剔除2例颈动脉频谱欠清晰者,2例手术取消者和3例入室后多次测量收缩压超过180 mmHg者后,最终纳入108例患者,其中麻醉诱导后43例(39.8%)发生低血压(低血压组),65例(60.2%)未发生低血压(非低血压组)。低血压组收缩压(systolic blood pressure,SBP)、平均动脉压(mean arterial pressure,MAP)以及ASA分级为Ⅲ级和合并高血压患者的占比均高于非低血压组,FTc短于非低血压组,VTI低于非低血压组,差异具有统计学意义(P均<0.05)。FTc预测PIH的ROC曲线下面积为0.899 (95%CI:0.766~0.920,P<0.05),灵敏度为86.0%,特异度为81.5%;VTI预测PIH的ROC曲线下面积为0.807 (95%CI:0.721~0.892,P<0.05),灵敏度为79.1%,特异度为75.4%;FTc与VTI联合预测PIH的ROC曲线下面积为0.909 (95%CI:0.853~0.965,P<0.05),灵敏度为95.3%,特异度75.4%。FTc和VTI联合预测PIH的效能高于FTc或VTI单独预测。FTc、VTI均与SBP下降百分比(decrease percentage of systolic blood pressure,SBP%)和MAP下降百分比(decrease percentage of mean arterial pressure,MAP%)呈负相关,且FTc与SBP%的相关性强于VTI%。FTc与SBP%呈中等负相关(r=-0.430,P<0.001),VTI与SBP%呈弱负相关(r=-0.240,P=0.012)。多因素Logistic回归分析结果显示,体重指数、年龄、ASA分级(Ⅲ级)、VTI、SBP、MAP差异无统计学意义(P均>0.05),而FTc差异有统计学意义(P<0.05)。结论 颈动脉FTc、VTI均能预测老年胃肠道肿瘤手术患者PIH的发生情况,但FTc的预测效能高于VTI,二者联合应用对老年胃肠道肿瘤手术患者发生PIH的预测效能高于FTc或VTI单独预测。

关键词： 色氨酸代谢   肿瘤微环境   免疫治疗  

摘要： 色氨酸(tryptophan,Trp)代谢在维持免疫稳态及肿瘤进展中具有关键作用,其代谢通路的紊乱,包括犬尿氨酸(kynurenine, Kyn)通路的异常活化,吲哚胺2,3-双加氧酶1(indoleamine 2,3-dioxygenase 1, IDO1)、色氨酸2,3-双加氧酶(tryptophan 2,3-dioxygenase, TDO)、白细胞介素4诱导蛋白1(interleukin-4-induced-1, IL4I1)等代谢关键酶的异常高表达和过度活化,以及肠道微生物产生的吲哚衍生物等,均可促进免疫抑制性肿瘤微环境(tumor microenvironment, TME)的形成。IDO1与TDO的过度活化不仅耗竭局部色氨酸,还促进免疫抑制性代谢物Kyn的积累,激活芳香烃受体(aryl hydrocarbon receptor, AHR)等多种信号通路,诱导调节性T细胞(regulatory T cell, Treg)分化、CD8+ T细胞耗竭、免疫检查点分子(例如PD-1)上调、M2型肿瘤相关巨噬细胞(tumor-associated macrophages, TAMs)及髓源性抑制性细胞(myeloid-derived suppressor cells, MDSCs)浸润等,从而促进免疫逃逸。尽管以IDO1抑制剂为代表的靶向治疗策略在临床前表现出良好潜力,但关键临床试验的失败提示,色氨酸代谢网络的复杂性与冗余性。本文系统综述了色氨酸代谢的3条主要代谢通路以及其异常代谢在肿瘤免疫微环境形成中的作用。通过综合分析色氨酸代谢靶向治疗的研究进展和现状,剖析了以IDO1抑制剂为代表的治疗策略失败的潜在原因和耐药机制,以及当前治疗策略的局限性,并探讨了未来多靶点联合干预以及IL4I1、AHR配体调节剂等新兴靶点探索的潜在方向。

关键词： 骨髓增生异常性肿瘤   急性髓系白血病   基因突变   染色体异常   预后分析  

摘要： 目的:探讨骨髓增生异常性肿瘤(Myelodysplastic Syndrome,MDS)患者向急性髓系白血病(Acute Myeloid Leukemia,AML)转化的风险因素,并评估其对患者预后的影响。方法:采用回顾性分析,纳入2015年4月至2023年6月在贵州医科大学附属医院确诊的281例MDS患者,根据是否转化为AML分为转白组和非转白组,收集患者的临床资料、实验室数据、基因突变及染色体核型分析结果。通过单因素和多因素Logistic回归分析筛选MDS向AML转化的独立风险因素,并采用Kaplan-Meier法进行生存分析,Cox比例风险模型评估预后相关因素。结果:转白组患者平均年龄显著高于非转白组(P=0.021);骨髓纤维化程度在转白组明显更重(P=0.010)。基因突变阳性率(57.1% vs. 31.0%)和染色体异常率(54.8% vs. 27.4%)在转白组显著升高(P<0.001),其中ASXL1、RUNX1突变及8q三体分布差异具有统计学意义(P<0.05)。IPSS-R评分及极高危分层在转白组占比更高(P<0.001)。多因素Logistic分析显示,RUNX1突变(OR=2.62,P=0.029)、8q三体(OR=2.41,P=0.043)、IPSS-R评分(OR=1.23,P=0.026)及极高危IPSS-R分层(OR=2.13,P=0.039)为独立转化风险因素。Cox回归分析表明,转化状态(HR=2.85,P<0.001)、年龄、基因突变、8q三体和RUNX1突变均为不良预后因素。转白组中位总体生存期为17.58个月,显著低于非转白组(58.31个月,P<0.001)。结论:高龄、突变等显著增加转化及预后风险。

关键词： Chemotherapy   Immuno- therapy   Neoadjuvant therapy   Stomach neoplasms, locally advanced   Targeted therapy  

摘要： 鉴于肿瘤组织内新生血管异常网络结构与功能常导致肿瘤微环境处于免疫抑制状态,使得免疫检查点抑制剂(ICI)与化疗等治疗肿瘤的疗效受到不同程度的限制,该现象系形成“冷肿瘤”的机制之一。实验研究与临床试验均发现,通过靶向调控肿瘤新生血管的生长,促使其结构与功能“正常化”,有利于肿瘤组织内免疫抑制微环境转变为免疫支持状态,促使“冷肿瘤”向“热肿瘤”转化,以提高ICI联合化疗的疗效。本文介绍近年来国内外针对局部晚期胃癌患者术前新辅助ICI、化疗和靶向肿瘤新生血管联合治疗的初步疗效,以供读者参考,并期待更多的临床研究进一步证实该治疗方案的获益性。.;In view of the abnormal network structure and function of newly formed blood vessels in tumor tissues, which often lead to an immunosuppressive state in the tumor microenvironment, resulting in varying degrees of limitations on the efficacy of immune checkpoint inhibitors (ICI) and chemotherapy. This phenomenon is one of the mechanisms underlying the formation of "cold tumors". Both experimental studies and clinical trials have found that targeted regulation of tumor neovascularization to promote the "normalization" of their structure and function is beneficial for transforming the tumor immunosuppressive microenvironment into an immunosupportive state. It enables the conversion of "cold tumors" to "hot tumors" to improve the efficacy of ICI combined with chemotherapy. This article introduces the preliminary efficacy of preoperative neoadjuvant ICI, chemotherapy combined with targeted tumor neovascular therapy for locally advanced gastric cancer(LAGC)in recent years, and we look forward to more clinical studies to further confirm the benefits of this treatment regimen.

关键词： Targeted drug delivery  

摘要： Bacterial outer membrane vesicles (OMVs) have attracted widespread attention in the field of drug delivery due to their excellent biocompatibility, tumor penetration, and loading capacity. The anti-angiogenic peptide AP25 can block malignant tumor angiogenesis and has broad-spectrum anti-cancer activity. To achieve efficient delivery of AP25, we modified AP25 on the surface of OMVs through genetic engineering and explored their inhibitory effects on breast cancer and gastric cancer in vitro. The results indicated that the engineered OMVs had typical morphological characteristics of OMVs, and the particle size distribution conformed to the theoretical. Proteinase K digestion combined with Western blotting confirmed that AP25 was modified on the membrane surface of OMVs. Cell experiments showed that WAP25 OMVs significantly inhibited the proliferation, migration, and invasion of MDA-MB-231 and HGC-27 cells, promoted the cell apoptosis, and downregulated the expression of tumor migration and angiogenesis-related proteins: integrin beta 1 (integrin β1), Homo sapiens inhibitor of DNA binding 1 (ID1), nuclear factor kappa-B (NF-κB), and vascular endothelial growth factor (VEGF). This study achieves effective delivery of protein drugs based on OMVs for the first time, providing new ideas for the anti-angiogenesis therapy for tumors and the functional development of bacterial OMVs. ©2026 Chin J Biotech, All rights reserved.

关键词： 初级纤毛   肿瘤   肿瘤抑制   肿瘤促进   Hedgehog信号通路   分子靶向治疗   肿瘤微环境   纤毛发生  

摘要： 初级纤毛(PC)是广泛存在于真核细胞表面的感觉细胞器,参与机械感知、信号转导、细胞周期及细胞极性等关键生物学过程。近年来研究表明,多种实体瘤中PC的数量和功能异常与肿瘤发生、进展及预后密切相关,但PC在肿瘤中的作用具有显著的双向性。为此,综述PC的结构、功能及其在肿瘤进展中的双重作用与靶向策略,可为阐明PC与肿瘤异质性的内在联系及开发新型精准治疗靶点提供理论依据。

关键词： Image processing, computer-assisted   Neoplasm invasiveness   Ovarian neoplasms  

摘要： Objective To investigate the potential value of quantitative digital pathology analysis in predicting prognosis in micropapillary serous borderline ovarian tumor (MP-SBOT). Methods Clinical and pathological data from 366 serous borderline ovarian tumor (BOT) patients who attended the First Affiliated Hospital of Nanjing Medical University between October 2012 and November 2023 were retrospectively reviewed. Patients were classified into MP-SBOT group and non-MP-SBOT group according to their pathological subtype. Within the MP-SBOT group, patients were further classified into recurrence and non-recurrence subgroups. Digital image analysis using QuPath was performed on 83 ovarian serous tumors with adequate tissue quality, including MP-SBOT (n=48), SBOT in the non-MP-SBOT group (n=9), serous cystadenoma (n=11), low-grade serous carcinoma (n=7) and high-grade serous carcinoma (n=8). Quantitative pathological features including nuclear area, cellular area, and nuclear-to-cytoplasmic ratio (N/C ratio) of tumor cells were extracted. Univariate and multivariate Cox regression analyses were used to identify factors associated with MP-SBOT recurrence. Kaplan-Meier method was applied to estimate progression-free survival (PFS) time. Results (1) Compared with non-MP-SBOT group, MP-SBOT group patients exhibited higher median serum carbohydrate antigen 125 level (127.9 vs 36.5 kU/L), higher D-Dimer level (0.7 vs 0.3mg/L), higher proportion of bilateral ovarian tumors (60.4% vs 15.4%), higher proportion of invasive peritoneal implants (25.0% vs 3.1%), higher proportion of International Federation of Gynecology and Obstetrics (FIGO) stage Ⅱ-Ⅲ (54.1% vs 10.0%), higher proportion of mixed cystic-solid mass detected by imaging examination (88.1% vs 70.1%) and higher proportion of recurrence (33.3% vs 13.5%) with statistically significant differences (all P<0.001). (2) Quantitative digital pathology revealed the distinct cellular morphologic characteristics in MP-SBOT. The tumor cell