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关键词： Appendiceal epithelial neoplasms   Comprehensive diagnosis and treatment   Expert consensus   Peritoneal metastasis   Prehabilitation  

摘要： 阑尾上皮肿瘤系指来源于阑尾黏膜上皮的肿瘤性病变,其病理特征与生物学行为具有高度异质性,因其结构和生物学行为的特殊性,具有较高的腹膜转移倾向。目前,关于阑尾上皮性肿瘤以及腹膜转移防治的循证医学证据有限,临床诊疗尚缺乏统一规范。为此,中国抗癌协会腹膜肿瘤整合康复专业委员会组织多学科专家,围绕阑尾上皮性肿瘤的病理分型和临床分期、局部切除术后扩大切除的指征、并发腹膜转移的外科治疗策略、围手术期康复及个体化治疗等关键环节,整合相关专科的技术力量;同时规范腹腔肿瘤减灭术与腹腔热灌注化疗围手术期管理以及预康复体系的临床应用,以提升实践可操作性。最终制定了《阑尾上皮肿瘤腹膜转移综合诊治专家共识(2025版)》,旨在进一步规范阑尾上皮性肿瘤的系统化诊治流程,以降低复发风险,改善患者预后,并推动其腹膜转移诊疗的标准化和同质化。.;Epithelial tumors of the appendix refer to neoplastic lesions originating from the epithelial tissue of the appendix mucosa. These neoplasms exhibit highly heterogeneous pathological features and biological behavior, which contribute to their strong propensity for peritoneal metastasis. Currently, evidence-based medicine regarding appendiceal epithelial neoplasms and the management of their peritoneal metastasis is limited, leading to a lack of standardized clinical practices. To address this, the Professional Committee of Integrated Rehabilitation for Peritoneal Tumors of the Chinese Anti-Cancer Association has organized multidisciplinary experts to focus on key aspects such as the pathological classification of epithelial tumors of the appendix, clinical staging of tumors,the indications for extended resection after local resection, the surgical treatment strategies for concurrent peritoneal metastasis, perioperative rehabilitation, and individualized treatment, while integrating the technical capabilities of relevant specialties. At the same time, it has standardized the perioperative management of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), as well as the clinical application of the pre-rehabilitation system, to enhance the practical operability. Ultimately, the Expert Consensus on the Comprehensive Management of Peritoneal Metastasis from Appendiceal Epithelial Neoplasms (2025 Edition) was developed. This consensus is aimed at further standardizing the systematic diagnosis and treatment process of epithelial tumors of the appendix, thereby reducing the risk of recurrenc

关键词： 胃肿瘤   生存分析   差异表达基因   WGCNA   MAGEA3   VWCE  

摘要： 背景:胃癌是全球最常见的消化道恶性肿瘤之一,其发展受多因素驱动,目前其有效分子标志物相对有限,难以满足精准预后评估和个体化治疗的临床需求.目的:通过整合多组学数据识别与胃癌发生、发展和预后相关的关键基因,并探讨其在肿瘤微环境中的表达特征.方法:基于TCGA‑STAD队列的转录组数据,进行差异表达基因(DEGs)分析与加权基因共表达网络分析(WGCNA),取交集,以获取候选关键基因,并进行GO和KEGG富集分析.进一步通过单因素Cox回归与LASSO回归分析筛选预后相关基因,并利用Kaplan‑Meier法验证其生存预测价值.结合GEO单细胞数据集GSE167297,分析关键基因在胃癌微环境细胞亚群中的表达分布.培养人胃癌细胞株HGC‑27和AGS,构建VWCE/MAGEA3过表达和敲低的稳转细胞株,以实时定量PCR法检测VWCE和MAGEA3 mRNA表达水平,CCK‑8法检测细胞增殖情况,流式细胞术术检测细胞周期分布或凋亡情况.结果:WGCNA识别出与胃癌组织显著正相关的MEblue模块,共筛选出4 514个DEGs,两者交集得到511个候选基因,富集分析显示其参与细胞周期、DNA复制、p53信号通路等过程.生存分析筛选出14个与总体生存显著相关的基因,其中MAGEA3和VWCE高表达提示患者预后不良(P<0.05).单细胞分析进一步揭示VWCE和MAGEA3在成纤维细胞中高表达.在HGC‑27细胞中,与阴性对照组相比,过表达组MAGEA3基因mRNA表达水平显著上调(P均<0.01),细胞活力显著增加(P<0.01),细胞凋亡受到抑制;而在AGS细胞中,与阴性对照组相比,敲低组VWCE基因mRNA表达水平显著下调(P<0.01),AGS细胞活力在所有时间点显著降低(P均<0.001),细胞凋亡增加.结论:MAGEA3和VWCE可能作为胃癌潜在的预后生物学标志物.

关键词： D2 radical resection   D2根治术   Evolution of treatment   Pathogenesis and evolution   Perioperative treatment   Stomach neoplasms   Survival analysis  

摘要： 目的: 总结我院(山西省肿瘤医院)11年间行胃癌D2根治术患者的临床病理特征、治疗策略和手术方式演变及生存情况,为本地区胃癌诊疗提供参考。 方法: 本研究采用回顾性观察性研究的方法,回顾性分析山西省肿瘤医院胃肠外科2013年1月至2023年12月期间,接受胃癌D2根治手术、且术后病理证实为胃腺癌或神经内分泌癌患者的临床病理资料。排除标准:(1)残胃癌及胃癌术后复发;(2)因出血、穿孔或梗阻等原因行急诊胃癌切除手术;(3)合并其他原发恶性肿瘤;(4)术前伴有严重心肺功能不全、肝肾功能不全不能耐受根治性手术者;(5)在病案查询系统、病理信息管理系统和胃癌专病数据库中患者主要诊断信息不一致者。根据治疗方式,分为单纯手术组、围手术期化疗组和辅助化疗组。观察指标包括:(1)患者基本情况;(2)肿瘤部位及病理特征演变;(3)治疗策略及手术方式演变;(4)生存情况。 结果: 共计15 644例患者纳入分析,男性12 591例,女性3 053例,男女性别比例约为4∶1;年龄(61.2±9.5)岁。肿瘤部位以食管胃结合部(EGJ)为主,呈先增后降趋势,整体占比57.4%;胃窦部肿瘤呈持平状态,整体占比25.9%;胃体肿瘤2020年后呈现缓慢增长趋势,整体占比16.7%。病理类型以低分化癌最为常见(55.9%),其余依次为中分化腺癌(24.2%)、黏液腺癌或印戒细胞癌(14.1%)、神经内分泌癌(4.8%)和高分化腺癌(0.9%);低分化腺癌呈先升后降趋势,2022年最高65.6%,2023年降为57.5%;黏液腺癌或印戒细胞癌呈现先升后降再升高的波动趋势,2018年峰值达17.3%,2022年降至8.4%,2023年回升至13.8%;高分化腺癌、中分化腺癌及神经内分泌肿瘤逐年呈持平状态。在病理分期方面,0期、Ⅰ期、Ⅱ期、Ⅲ期及Ⅳa期胃癌整体占比0.5%、17.3%、25.1%、54.9%及2.3%。Ⅲ期胃癌在2013年占比达74.6%,到2023年占比为46.4%,呈现下降趋势。2013年Ⅰ期、Ⅱ期胃癌占比分别为10.2%和12.1%,2023年分别为21.0%和29.6%,呈上升趋势。2013—2023年间,仅接受手术的患者数量持续走低,至2023年该比例降至34.7%;而接受辅助化疗的患者数量逐年上升,至2023年达到54.2%;自2017年起,围手术期化疗的应用占比逐渐增多,至2023年增至11.1%。免疫疗法与围手术期化疗呈现出近乎同步的增长趋势,然而靶向疗法在经历了一段增长期后,又呈现出下降的趋势。手术方式中,经腹开放手术10 704例(68.4%),腹腔镜手术4 744例(30.3%),经胸手术193例(1.2%)。胃癌手术总量逐渐增高,到2021年到达顶峰,随后胃癌手术量逐渐降低,腹腔镜手术并没有减少,反而呈增长趋势。病理切缘阳性443例(2.8%)。手术方式中,食管胃结合部肿瘤切除方式主要为全胃切除(78.5%),其次为近端胃切除(21.5%)。全胃切除术后食管空肠Roux-en-Y吻合是主要吻合方式,近端胃切除术后吻合方式主要是食管管胃吻合(68.0%),远段胃切除术后毕Ⅱ吻合术是主要吻合方式(92.7%)。术后并发症发生率为14.5%(2 264/15 644),其中Ⅲ~Ⅳ级严重并发症发生率为4.5%(706/15 644)。全组随访(47.1±36.8)个月,1、3、5年的总体生存率分别为86.4%、65.9%和58.1%;0期、Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期胃腺癌患者1年总体生存率分别为95.7%、98.0%、89.4%、81.0%和49.1%,3年总体生存率则分别为92.1%、94.6%、81.9%、51.4%和14.7%,5年总体生存率则分别为89.4%、91.7%、75.1%、41.5%和10.0%;Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期胃神经内分泌癌患者1年总体生存率分别为96.7%、91.1%和73.8%和52.6%,3年总体生存率则分别为87.2%、69.6%、46.1%和32.1%,5年总体生存率分别为87.2%和62.2%和36.7%和32.1%。 结论: 山西省胃癌发病具有男性多见、好发于食管胃结合部、低分化癌占比高、Ⅲ期病例高发的特点,早期胃癌发现率逐年提高,腹腔镜手术量逐年升高,治疗模式已从单一手术向综合治疗转变。.;Objective: To summarize the clinicopathological features, evolving trends in treatment and surgical approaches, and survival outcomes of patients who underwent D2 radical gastrectomy for gastric cancer in S

关键词： Circumferential location   Circumferential resection margin   Local recurrence   mid-low   Rectal neoplasms  

摘要： 目的: 探讨直肠肿瘤环周位置(直肠前壁、非前壁或环周)对中低位直肠癌患者环周切缘状态、局部复发及生存的影响。 方法: 本研究采用回顾性队列研究方法。分析2018年12月至2019年12月期间,海军军医大学第一附属医院肛肠外科收治的696例中低位直肠腺癌手术患者的病历资料。基于MRI或增强CT检查所见肿瘤位置,将直肠壁分为前、后、左、右4个分区,有245例患者肿瘤主体位于前壁,即为前壁组;286例肿瘤主体位于后壁或侧壁,为非前壁组;165例肿瘤侵犯范围≥3/4肠周,为环周组。采用倾向性评分匹配(PSM)平衡组间的基线资料差异,比较3组患者手术的病理环周切缘阳性率及术后局部复发率(LRR)、总生存期(OS)和无病生存期(DFS)。采用Cox回归分析肿瘤复发的危险因素。对未行新辅助治疗的患者进行分期亚组分析。 结果: PSM后,前壁组和环周组病理环周切缘阳性率显著高于非前壁组(分别为P=0.040和P=0.039)。全组中位随访时间64(1~71)个月。前壁组与非前壁组比较,前壁组5年LRR显著升高(8.8%比2.3%,P=0.003),5年OS(80.7%比91.6%,P=0.001)和DFS(76.6%比84.6%,P=0.029)明显降低;环周组与非前壁组比较,5年LRR(11.4%比3.8%,P=0.020)显著更高,但5年OS(81.8%比89.5%,P=0.100)和DFS(70.7%比78.3%,P=0.101)差异无统计学意义。前壁组与环周组比较,5年LRR(11.1%比9.7%)、OS(76.3%比83.7%)和DFS(69.8%和74.1%)差异均无统计学意义(均P>0.05)。Cox单因素和多因素分析显示,前壁肿瘤(HR=3.751,95%CI:1.373~10.215,P=0.010)、环周肿瘤(HR=3.240,95%CI:1.109~9.466,P=0.032)和病理环周切缘阳性(HR=3.071,95%CI:1.144~8.245,P=0.026)以及有淋巴结转移(HR=2.584,95%CI:1.192~5.601,P=0.016)是本组患者发生局部复发的独立危险因素,而肿瘤距肛缘距离越远(每增加1 cm,HR=0.831,95%CI:0.712~0.970,P=0.019)和接受新辅助治疗(HR=0.442,95%CI:0.204~0.957,P=0.038)则是本组患者发生局部复发的独立保护因素。未接受新辅助治疗的局部进展期非前壁肿瘤呈现超低本组患者局部复发(pⅡ~Ⅲ期1.3%,pT3~4期1.6%)。 结论: 位于前壁及环周的直肠肿瘤CRM阳性率和局部复发风险更高、生存更差,应优先进行新辅助治疗。非前壁肿瘤复发率低,可考虑选择性豁免新辅助治疗。.;Objective: To investigate the impact of circumferential tumor location (anterior wall, nonanterior wall, or circumferential) on circumferential resection margin (CRM) status, local recurrence, and survival in patients with mid-low rectal cancer. Methods: A retrospective cohort study was conducted using data from 696 patients with mid-low rectal adenocarcinoma who underwent surgery in the Department of Colorectal Surgery at the First Affiliated Hospital of Naval Medical University between December, 2018 and December, 2019. Based on MRI or contrast-enhanced CT findings, the rectal wall was divided into four quadrants: anterior, posterior, left, and right. Tumors were classified into three groups: anterior wall group (n = 245), nonanterior wall group (n = 286, tumors predominantly located on the posterior or lateral walls), and cir

关键词： Tumors  

摘要： The ubiquitin-proteasome system (UPS) serves as the central mechanism for protein degradation in eukaryotic cells. Deubiquitinases (DUBs), which maintain protein stability and function by removing ubiquitin chains play a key role in protein cycling. Consequently, a DUB-targeting chimera (DUBTAC) technology has emerged. A DUBTAC consists of three components: a protein-targeting ligand, a DUB recruiter, and a linker connecting them. A DUBTAC can simultaneously bind to its targeted protein and DUB and induce the DUB to cleave the ubiquitin chains, thereby restoring the protein function by stabilizing the target protein. The DUBTAC technology provides a novel research strategy involving targeted protein stabilization for conventionally "undruggable" proteins that are abnormally degraded. Compared with other mature technologies, such as proteolysis-targeting chimera (PROTAC) and molecular glue degrader technologies, the DUBTAC technology has the unique advantages of targeting and stabilizing tumor suppressors, thus showing high potential for cancer therapy. However, it is still in the early stage of development with few systematic summaries of recent research achievements. This review introduces the basic concepts, critical design, and research considerations of DUBTACs, summarizes the latest research advances in DUBTAC technology for antitumor drug development, and discusses the development strategies and clinical application prospects of DUBTACs in the future, aiming to provide more directions for research on this technology. ©2025 Chin J Biotech, All rights reserved.

关键词： 结直肠肿瘤   骨髓源性肌成纤维细胞   转化生长因子β   信号转导与转录激活因子3  

摘要： 背景:骨髓源性肌成纤维细胞(BMFs)在结直肠癌发生、发展和肿瘤耐药中起重要作用,但目前尚缺乏特异性抑制BMFs的药物.目的:探索靶向抑制BMFs来源的转化生长因子‑β(TGF‑β)和信号转导与转录激活因子3(STAT3)信号对结直肠癌生长的影响.方法:将结直肠癌细胞株MC38与BMFs共培养,体外观察BMFs对MC38细胞生长的影响.构建MC38细胞与BMFs混合细胞小鼠皮下移植瘤模型,研究BMFs对MC38细胞体内皮下移植瘤生长的影响.应用转录组测序和免疫组化技术分析BMFs来源的TGF‑β、STAT3等信号通路在结直肠癌生长中的作用.应用TGF‑β和STAT3特异性抑制剂治疗BMF+MC38混合细胞皮下移植瘤,探索靶向BMFs来源的TGF‑β和STAT3信号以抑制BMFs对结直肠癌促生长作用的疗效和安全性.结果:体外共培养实验显示BMFs在体外能显著促进MC38细胞增殖和生长(P<0.01).小鼠皮下移植瘤实验结果显示,BMFs能显著促进体内MC38细胞移植瘤生长(P<0.001).免疫组化结果证实,BMF+MC38混合移植瘤中的TGF‑β1和p‑STAT3含量显著高于MC38细胞移植瘤(P<0.01),提示BMFs来源的TGF‑β和STAT3可促进结直肠癌生长.应用TGF‑β和STAT3信号特异性小分子抑制剂治疗BMF+MC38混合移植瘤,可显著抑制混合移植瘤生长(P<0.000 1),未见明显毒性反应.结论:BMFs能显著促进MC38细胞的体内外生长,靶向抑制TGF‑β和STAT3信号能显著抑制BMFs介导的促结直肠癌生长作用.

关键词： 吡唑   CDK2   HDAC   抑制剂   抗肿瘤   苯乙酮   氨基脲盐酸盐   医药原料  

摘要： 为获取更好的抗肿瘤活性候选化合物，以苯乙酮、氨基脲盐酸盐等为原料，通过缩合、环化及水解等工艺合成了9种含羟肟酸基团的吡唑类衍生物Ⅵa～Ⅵi。经1HNMR、13CNMR和质谱对其进行了结构确证，并评价了其对肿瘤细胞和CDK2/HDAC酶的抑制活性。结果表明，部分化合物表现出与阳性对照Olomoucine和SAHA相当甚至更优的抗肿瘤活性。其中，化合物{4-[（环己基）甲基]-3-苯基-1H-吡唑-1-基}-N-羟基丁酰胺（Ⅵe）、{3-4-[（环丙基）甲基]-3-苯基-1H-吡唑-1-基}-N-羟基丁酰胺（Ⅵf）对肿瘤细胞株MCF-7和B16-F10均表现出较高的抗增殖活性，两者之间可能存在协同作用。化合物Ⅵe、Ⅵf表现出最强的CDK2和HDAC抑制活性，表明吡唑环和羟肟酸基团的连接链长度对HDAC抑制活性的影响非常关键，碳链长度为3可能最合适。分子对接结果表明，化合物Ⅵf可能是一种有效的双CDK2/HDAC抑制剂，其与CDK2、HDAC均形成了良好的结合模型，可作为基于CDK2/HDAC双靶点抗癌药物的活性化合物进一步优化。

关键词： 甲状腺肿瘤   风险护理   植入式静脉输液港  

摘要： 目的　探讨风险护理干预在植入式静脉输液港甲状腺肿瘤患者中的应用效果。方法　选取 2022 年 1 月至 2025 年 1 月于医院接受植入式静脉输液港辅助治疗的 94 例甲状腺肿瘤患者，以随机抽签法分为两组，每组 47 例。对照组行常规护理干预，观察组在对照组基础上联合风险护理干预。比较两组并发症情况、输液港维护依从性、护理规范性、生活质量 [ 癌症患者生活功能指标量表（FLIC）评分 ]。结果　干预后，观察组植入式静脉输液港所致并发症发生率低于对照组（P < 0.05）;观察组输液港维护依从率高于对照组（P < 0.05）;观察组护理操作规范性评分高于对照组（P < 0.05）;观察组 FLIC 评分高于对照组（P < 0.05）。结论 风险护理干预能够有效降低甲状腺肿瘤患者接受植入式静脉输液港治疗导致的并发症发生风险，提高患者的输液港维护依从性、护理规范性及生活质量。

关键词： China   Neoplasms   R package   Registration   Software  

摘要： Objective: To develop a tool package that meets the routine statistical analysis requirements of population-based cancer registries in China based on R language, with the aim of improving data quality and efficiency, and promoting the nationwide scientific utilization of cancer registry data. Methods: The functional demands for statistical analysis of population-based cancer registry staff were collected through questionnaires or face-to-face interviews. Based on the concept of generic functions in R software's S3 object system, functions were developed by defining specific S3 classes for different data types, allowing the same function to perform diverse tasks depending on the class of input data. A stepwise development strategy was adopted to ensure logical coherence among functional modules, and all functions were systematically tested and validated in accordance with standard R package development guidelines. Results: Six categories of functions, including data reading, data manipulation, data processing, statistical calculation, visualization, and statistical reporting, were developed to support routine statistical analysis of population-based cancer registry data. Data reading functions support reading data formats required by the National Cancer Registry. Data manipulation functions empower conditional filtering of registry data and support regrouping, merging, or transforming the data based on registry attributes (such as urban/rural location) to accommodate different analytical needs. Data processing functions includes age grouping, International Classification of Diseases 10^th Revision (ICD-10) classification, childhood cancer classification, and population estimation. Statistical calculation functions permit the calculation of age-standardized rates, truncated rates, cumulative rates, cumulative risks, life tables, and expansion from abridged to complete life tables. Visualization functions can generate commonly used statistical charts, includi

关键词： UBE2M   类泛素化Neddylation修饰   肿瘤   炎症   肥胖   抗病毒免疫  

摘要： NEDD8结合酶E2M(UBE2M/UBC12)是一种神经前体细胞表达发育性下调因子8(NEDD8)结合酶，它能够催化底物蛋白发生类泛素化Neddylation修饰。UBE2M在多种恶性肿瘤中过度表达，与患者总体生存率呈显著负相关。UBE2M通过抑制凋亡/衰老或促进增殖，进而加速肿瘤生长。UBE2M还在炎症、自身免疫性疾病和抗病毒免疫中发挥重要作用。本文重点介绍了UBE2M在肿瘤与非肿瘤疾病发生发展中的最新进展，揭示了NEDD8结合酶UBE2M可能是作为多种疾病治疗的关键靶点。